Organization
HAVEN HOUSE, INC .
Active
Parent organization
HAVEN HOUSE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN HOUSE, INC
Authorized official
JESSIE COSTLEY (CREDENTIALING SPECIALIST)
(443) 839-6928
Entity
Organization
Contact information
Practice address
1195 AUGUSTINE HERMAN HWY, ELKTON, MD 21921-8252
(410) 398-9900
Mailing address
1195 AUGUSTINE HERMAN HWY, ELKTON, MD 21921-8252
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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