Organization
HEAVENLY HAVEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY NELSON (CEO)
(225) 355-2498
Entity
Organization
Contact information
Practice address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
(255) 357-6424
Mailing address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
(255) 357-6424
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
7258
LA
385H00000X
Respite Care
7254
LA
Other
Enumeration date
04/28/2006
Last updated
09/11/2025
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