Organization
HAVEN BEHAVIORAL SERVICES OF PUEBLO, LLC
Active
Parent organization
HAVEN BEHAVIORAL HEALTHCARE INC.
Other names
Haven Behavioral Hospital of Southern Colorado
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN BEHAVIORAL HEALTHCARE INC.
Authorized official
CHRISTY A KELTNER (AVP / REVENUE CYCLE)
(615) 393-8816
Entity
Organization
Contact information
Practice address
1008 MINNEQUA AVE, SUITE 6100, PUEBLO, CO 81004-3733
(719) 546-6000
(719) 565-4021
Mailing address
1008 MINNEQUA AVE, SUITE 6100, PUEBLO, CO 81004-3733
(719) 546-6000
(719) 565-4021
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
01P254
CO
283Q00000X
Psychiatric Hospital
APPLIED FOR
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064025
MEDICARE A
CO
Enumeration date
05/10/2007
Last updated
06/15/2015
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