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General NPI Number Information
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NPI Number | 1265363014
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Entity Type | Organization
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Legal Business Name | HAVEN CREST OPERATIONS CO LLC
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Dates
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Enumeration Date | 05/28/2026
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Last Update Date | 05/28/2026
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Provider Practice Location Address
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Address Line | 2602 S ENSENADA WAY
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City | AURORA
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State | CO
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Zip | 80013-7690
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Country | US
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Telephone | 720-450-9760
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Fax |
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Provider Business Mailing Address
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Address Line | 2602 S ENSENADA WAY
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City | AURORA
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State | CO
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Zip | 80013-7690
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Country | US
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Telephone | 720-450-9760
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RACHEL MARIE EVERETT
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Credential |
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Telephone | 573-452-3214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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