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General NPI Number Information
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NPI Number | 1780494435
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Entity Type | Organization
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Legal Business Name | HAVEN TREATMENT CENTER - WASHINGTON
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2805 E 19TH ST
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City | VANCOUVER
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State | WA
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Zip | 98661-4614
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Country | US
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Telephone | 564-464-3644
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Fax |
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Provider Business Mailing Address
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Address Line | 7460 WARREN PKWY STE 180
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City | FRISCO
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State | TX
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Zip | 75034-4170
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Country | US
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Telephone | 214-754-9739
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Fax | 214-548-4159
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Authorized Official
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Title or Position | CEO
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Name | MARGIE BARILLA
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Credential |
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Telephone | 214-754-9739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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