Organization
BLUE HAYVEN FOUNDATION
Active
Parent organization
BLUE HAYVEN FOUNDATION
Other names
none at this time
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUE HAYVEN FOUNDATION
Authorized official
MRS. NICOLE MICHEELE BROCK-WILLIAMS (DIRECTOR)
(314) 440-8087
Entity
Organization
Contact information
Practice address
36 JULIE LN, SAINT PETERS, MO 63376-2147
(314) 440-8087
(314) 395-6121
Mailing address
36 JULIE LN, SAINT PETERS, MO 63376-2147
(314) 440-8087
(314) 395-6121
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
07/12/2008
Last updated
07/12/2008
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