# BLUE HAVEN GROUP CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447798806
- **Authorized official:** MR. LUIS J. ARIZA (PRESIDENT)
- **Authorized official phone:** (954) 540-6470

## Contact information

- **Practice address:** 3241 NW 108TH DR, CORAL SPRINGS, FL 33065-3528
- **Practice address phone:** (954) 540-6470
- **Practice address fax:** (954) 796-7104
- **Mailing address:** 3241 NW 108 DR., CORAL SPRINGS, FL 33065
- **Mailing address phone:** (654) 588-1916
- **Mailing address fax:** (954) 796-7104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 10-2794GH | FL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 10-2899GH | FL | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 10-2941GH | NULL | — |

## Other

- **Enumeration date:** 02/06/2017
- **Last updated:** 02/06/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 682933396 | — | FL |