Organization
HAVEN HOUSE COMMUNITY SUPPORT CENTER LLC
Active
Other names
Safe Haven Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA OLSON (OWNER)
(715) 339-6453
Entity
Organization
Contact information
Practice address
548 N LAKE AVE, PHILLIPS, WI 54555-1028
(715) 339-6453
(715) 339-6450
Mailing address
548 N LAKE AVE, PHILLIPS, WI 54555-1028
(715) 339-6453
(715) 339-6450
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2793
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42255200
—
WI
Enumeration date
07/03/2008
Last updated
02/14/2012
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