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General NPI Number Information
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NPI Number | 1003608183
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Entity Type | Organization
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Legal Business Name | GENTLE HAVEN, LLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 70 W STREETSBORO ST STE 306
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City | HUDSON
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State | OH
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Zip | 44236-5113
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Country | US
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Telephone | 234-380-2531
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Fax |
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Provider Business Mailing Address
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Address Line | 70 W STREETSBORO ST STE 306
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City | HUDSON
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State | OH
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Zip | 44236-5113
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Country | US
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Telephone | 234-380-2531
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NONI BROOKS
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Credential |
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Telephone | 216-213-9848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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