# SECOND HAVEN SERVICES FOR YOUTH INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rose Resiliency Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053649178
- **Authorized official:** MR. WILLIAM FREEMAN IV MBA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (866) 343-5509

## Contact information

- **Practice address:** 633 LAKESIDE DR, TOBYHANNA, PA 18466-9792
- **Practice address phone:** (866) 343-5509
- **Practice address fax:** (866) 343-5509
- **Mailing address:** PO BOX 329, MOUNT POCONO, PA 18344-0329
- **Mailing address phone:** (866) 343-5509
- **Mailing address fax:** (866) 343-5509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TP0016X | Prescribing (Medical) Psychologist | MD037460L | PA | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 223180 | PA | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 221370 | PA | Yes |

## Other

- **Enumeration date:** 12/01/2009
- **Last updated:** 02/09/2015