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Organization
HAVEN HOUSE TREATMENT CENTER CORP
Active
Organization
HAVEN HOUSE TREATMENT CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIETA B SICAT (EXECUTIVE DIRECTOR)
(503) 267-8012
Entity
Organization
Contact information
Practice address
13565 SW SINGLETREE DR, BEAVERTON, OR 97008-7517
(503) 521-0405
Mailing address
PO BOX 230102, TIGARD, OR 97281-0102
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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