Haven Manor LLC
Community Based Residential Treatment Facility, Mental Illness in Surprise, AZ. Organization (NPI-2).
NPI number1255170858
StatusActive
Last updated in NPPESMay 22, 2024
Details
- NPI
- 1255170858
- Entity type
- Organization (NPI-2)
- Legal business name
- Haven Manor LLC
- Organization subpart
- No
- Enumeration date
- May 22, 2024
- Certification date
- May 22, 2024
- Last updated
- May 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
Practice location
13594 W Post DrSurprise, AZ 85374-5405
Phone 623-203-0771
Mailing address
13594 W Post DrSurprise, AZ 85374-5405
Phone 623-203-0771
Authorized official
Virginia Nganga
Operations Manager
6232030771
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