# HAVEN HOUSE TREATMENT CENTER CORP

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

## Provider details

- **NPI number:** 1588921845
- **Authorized official:** MS. JULIETA B SICAT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (503) 267-8012

## Contact information

- **Practice address:** 13565 SW SINGLETREE DR, BEAVERTON, OR 97008-7517
- **Practice address phone:** (503) 521-0405
- **Mailing address:** PO BOX 230102, TIGARD, OR 97281-0102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2012
- **Last updated:** 04/11/2012