Provider Demographics
NPI:1346588142
Name:BETHLEHEM HAVEN
Entity Type:Organization
Organization Name:BETHLEHEM HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MUFAKA-MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-391-1348
Mailing Address - Street 1:905 WATSON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4709
Mailing Address - Country:US
Mailing Address - Phone:412-391-1348
Mailing Address - Fax:
Practice Address - Street 1:905 WATSON ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4709
Practice Address - Country:US
Practice Address - Phone:412-391-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness