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General NPI Number Information
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NPI Number | 1518275759
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Entity Type | Organization
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Legal Business Name | HAVEN BEHAVIORAL SERVICES OR READING, LLC
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 640 WALNUT ST SUITE 303
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City | READING
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State | PA
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Zip | 19601-3504
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Country | US
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Telephone | 610-208-8860
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Fax | 610-208-8861
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Provider Business Mailing Address
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Address Line | 652 W IRIS DR
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City | NASHVILLE
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State | TN
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Zip | 37204-3191
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Country | US
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Telephone | 615-250-9500
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Fax | 615-250-9516
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Authorized Official
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Title or Position | VP/CORP COMPLIANCE&GENERAL COUNSEL
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Name | MR. KIRK MCCONNELL
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Credential |
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Telephone | 615-250-9160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 222170
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License Number State | PA
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