Organization
GRACE HAVEN MANAGEMENT, INC.
Active
Other names
Grace Haven House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARLYN CLEVERT SMITH (CAO/PROGRAM DIRECTOR)
(804) 779-2356
Entity
Organization
Contact information
Practice address
6111 MAGAZINE DR, MECHANICSVILLE, VA 23111-4540
(804) 779-2356
(804) 779-7566
Mailing address
PO BOX 2012, MECHANICSVILLE, VA 23116-0010
(804) 779-2356
(804) 779-7566
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
SS-269-06
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010217245
—
VA
Enumeration date
08/10/2006
Last updated
09/19/2008
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