Organization
HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC
Active
Other names
Haven Senior Horizons Outpatient
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM PAGE BARNES (CFO/SECRETARY)
(615) 250-9091
Entity
Organization
Contact information
Practice address
16620 N 40TH ST, SUITE I-1, PHOENIX, AZ 85032-3348
(602) 923-5845
(602) 923-5846
Mailing address
652 W IRIS DR, NASHVILLE, TN 37204-3191
(615) 250-9500
(615) 250-9515
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
BH-3156
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442893
—
AZ
Enumeration date
06/17/2008
Last updated
07/31/2009
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