Provider Demographics
NPI:1104371921
Name:GIRLS' HAVEN
Entity Type:Organization
Organization Name:GIRLS' HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCNEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-832-6223
Mailing Address - Street 1:3380 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-3840
Mailing Address - Country:US
Mailing Address - Phone:409-832-6223
Mailing Address - Fax:409-813-2766
Practice Address - Street 1:3380 FANNIN ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-3840
Practice Address - Country:US
Practice Address - Phone:409-832-6223
Practice Address - Fax:409-813-2766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children