Organization
HAVEN DETOX LR OPERATING SUBSIDIARY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MOORE (AUTHORIZED OFFICIAL)
(561) 517-3400
Entity
Organization
Contact information
Practice address
5201 STAGECOACH RD, LITTLE ROCK, AR 72204-8515
(501) 406-0903
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
01/27/2026
Last updated
03/25/2026
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