Provider Demographics
NPI:1346348554
Name:HAVEN HOUSE INCORPORATED
Entity Type:Organization
Organization Name:HAVEN HOUSE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RIEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:919-833-3312
Mailing Address - Street 1:706 HILLSBOROUGH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1656
Mailing Address - Country:US
Mailing Address - Phone:919-833-3312
Mailing Address - Fax:919-833-3512
Practice Address - Street 1:706 HILLSBOROUGH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1656
Practice Address - Country:US
Practice Address - Phone:919-833-3312
Practice Address - Fax:919-833-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty