Organization
HAVEN YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREL CALLIS (OWNER)
(804) 833-2879
Entity
Organization
Contact information
Practice address
3122 W MARSHALL ST, RICHMOND, VA 23230-4726
(804) 340-5220
(804) 340-5222
Mailing address
3122 W MARSHALL ST, RICHMOND, VA 23230-4726
(804) 340-5220
(804) 340-5222
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
SS18205
VA
Other
Enumeration date
12/11/2006
Last updated
08/22/2020
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