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General NPI Number Information
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NPI Number | 1316859895
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Entity Type | Organization
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Legal Business Name | HAVEN TREATMENT HOMESTEAD
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 11321 US HIGHWAY 50
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City | KNOB NOSTER
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State | MO
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Zip | 65336-3108
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Country | US
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Telephone | 660-233-3862
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Fax |
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Provider Business Mailing Address
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Address Line | 11321 US HIGHWAY 50
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City | KNOB NOSTER
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State | MO
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Zip | 65336-3108
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Country | US
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Telephone | 660-233-3862
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Fax |
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Authorized Official
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Title or Position | OWNER/OPORATER
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Name | MRS. SHANNA NAOMI DANCY
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Credential | LPC
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Telephone | 660-233-3862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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