Organization
HAVEN HOUSE, INC .
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE COSTLEY (CREDENTIALING SPECIALIST)
(443) 839-6928
Entity
Organization
Contact information
Practice address
1195 AUGUSTINE HERMAN HWY, ELKTON, MD 21921-8252
(410) 398-9900
Mailing address
1195 AUGUSTINE HERMAN HWY, PO BOX 723, ELKTON, MD 21921-8252
(410) 398-9900
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
8314
MD
Other
Enumeration date
12/06/2005
Last updated
07/25/2024
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