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NPI Code Detail

MEDICARE: HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC

MEDICARE: HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283Q00000XPsychiatric Hospital

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2Z136159OTHERAZMEDICARE B

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275716896
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC
Provider Business Mailing Address
First Line : 3102 W END AVE STE 1000
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1324
Country : US
Telephone Number : 615-398-8800
Fax Number : 615-982-9829
Provider Business Practice Location Address
First Line : 1201 S 7TH AVE
Second Line : SUITE 200
City : PHOENIX
State : AZ
Zip : 85007-3913
Country : US
Telephone Number : 623-236-2000
Fax Number : 623-236-2050
Authorized Official
Title or Position : EVP
Name : LAURA TARANTINO
Credential :
Telephone Number : 972-464-0022
Provider Enumeration Date : 12/06/2007
Last Update Date : 03/12/2025

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