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General NPI Number Information
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NPI Number | 1740452283
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Entity Type | Organization
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Legal Business Name | YOUTH HAVEN INC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 5867 WHITAKER ROAD
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City | NAPLES
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State | FL
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Zip | 34112
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Country | US
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Telephone | 239-774-2904
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Fax | 239-774-0801
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Provider Business Mailing Address
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Address Line | 5867 WHITAKER ROAD
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City | NAPLES
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State | FL
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Zip | 34112
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Country | US
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Telephone | 239-774-2904
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Fax | 239-774-0801
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CHARLES R MCSWINEY
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Credential |
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Telephone | 239-774-2904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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