# PINE HAVEN BOYS CENTER, INC.

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

## Provider details

- **NPI number:** 1972729747
- **Authorized official:** JOHN B. VITALI (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (603) 485-7141

## Contact information

- **Practice address:** 133 RIVER RD, ALLENSTOWN, NH 03275-2362
- **Practice address phone:** (603) 485-7141
- **Practice address fax:** (603) 485-7142
- **Mailing address:** 133 RIVER RD, PO BOX 162, ALLENSTOWN, NH 03275-2362
- **Mailing address phone:** (603) 485-7141
- **Mailing address fax:** (603) 485-7142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 1073 | NH | Yes |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30007076 | — | NH |