Organization
HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC
Active
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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