Provider Demographics
NPI:1366683658
Name:HAVEN BEHAVIORAL SERVICES OF DENVER, LLC
Entity Type:Organization
Organization Name:HAVEN BEHAVIORAL SERVICES OF DENVER, LLC
Other - Org Name:HAVEN BEHAVIORAL SENIOR CARE OF NORTH DENVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-250-9160
Mailing Address - Street 1:652 W IRIS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3191
Mailing Address - Country:US
Mailing Address - Phone:615-250-9500
Mailing Address - Fax:615-250-9515
Practice Address - Street 1:8451 PEARL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4804
Practice Address - Country:US
Practice Address - Phone:303-288-7000
Practice Address - Fax:615-250-9516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAVEN BEHAVIORAL SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-16
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90854748Medicaid
CO90854748Medicaid
COCOB5049Medicare PIN