Organization
THE HAVEN HALFWAY HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS RUSSELL AUSTAD LADC (CHIEF EXECUTIVE OFFICER)
(320) 293-3418
Entity
Organization
Contact information
Practice address
32524 MEADOW LN, SAINT JOSEPH, MN 56374-9760
(320) 202-7881
Mailing address
32524 MEADOW LN, SAINT JOSEPH, MN 56374-9760
(320) 293-3418
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1044351
MN
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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