Organization
HAVEN NEW ENGLAND: MH
Active
Parent organization
HAVEN DETOX MA
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN DETOX MA
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 635-2400
Entity
Organization
Contact information
Practice address
1369 GRAFTON ST, WORCESTER, MA 01604-2737
(561) 635-2400
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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