Organization
HAVEN ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 396-5849
Entity
Organization
Contact information
Practice address
3161 S PROSPEROUS PL, GREEN VALLEY, AZ 85614-6403
(561) 635-2400
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/20/2023
Last updated
02/19/2025
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