Organization
A WILLOW HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORY WELLS (EXECUTIVE DIRECTOR)
(606) 505-7300
Entity
Organization
Contact information
Practice address
400 ELIZABETH DR, HAZARD, KY 41701-1228
(606) 505-7300
Mailing address
400 ELIZABETH DR, HAZARD, KY 41701-1228
(606) 505-7300
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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