Organization
HAVEN ADOLESCENT COMMUNITY RESPITE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA TAUBE LSW (OPERATIONAL DIRECTOR)
(201) 433-3891
Entity
Organization
Contact information
Practice address
13 ROOSEVELT AVE, JERSEY CITY, NJ 07304-1207
(201) 433-3891
Mailing address
53 DUNCAN AVE APT 21, JERSEY CITY, NJ 07304-2150
(201) 433-3891
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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