Provider Demographics
NPI:1275310807
Name:HATCH HAVEN, LLC
Entity Type:Organization
Organization Name:HATCH HAVEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NORBUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-815-6490
Mailing Address - Street 1:PO BOX 2937
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-2937
Mailing Address - Country:US
Mailing Address - Phone:480-815-6490
Mailing Address - Fax:480-393-1898
Practice Address - Street 1:2720 E BROOKS ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-8854
Practice Address - Country:US
Practice Address - Phone:480-815-6490
Practice Address - Fax:480-393-1898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HATCH HAVEN, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-08
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities