# BLUE HAYVEN FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BLUE HAYVEN FOUNDATION
- **Other names:** none at this time
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518121128
- **Legal business name:** BLUE HAYVEN FOUNDATION
- **Authorized official:** MRS. NICOLE MICHEELE BROCK-WILLIAMS (DIRECTOR)
- **Authorized official phone:** (314) 440-8087

## Contact information

- **Practice address:** 36 JULIE LN, SAINT PETERS, MO 63376-2147
- **Practice address phone:** (314) 440-8087
- **Practice address fax:** (314) 395-6121
- **Mailing address:** 36 JULIE LN, SAINT PETERS, MO 63376-2147
- **Mailing address phone:** (314) 440-8087
- **Mailing address fax:** (314) 395-6121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2008
- **Last updated:** 07/12/2008