Organization
HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE COUNTY
Active
Parent organization
HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE COUNTY
Other names
Haven House Community Support Center of Price Co
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE COUNTY
Authorized official
MS. PAMELA MARIE OLSON LICENSED CLINICAL SO (CLINICAL COORDINATOR)
(715) 339-6449
Entity
Organization
Contact information
Practice address
548 N LAKE AVE, PHILLIPS, WI 54555
(715) 339-6449
(715) 339-6450
Mailing address
548 N LAKE AVE, PHILLIPS, WI 54555
(715) 339-6449
(715) 339-6450
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
753145419
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43429400
—
WI
Enumeration date
04/11/2008
Last updated
10/20/2008
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