Provider Demographics
NPI:1568827418
Name:THE HAVEN AT COLLEGE
Entity Type:Organization
Organization Name:THE HAVEN AT COLLEGE
Other - Org Name:RECOVERY GRADS
Other - Org Type:Other Name
Authorized Official - Title/Position:CO FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-480-7129
Mailing Address - Street 1:PO BOX 18379
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-0379
Mailing Address - Country:US
Mailing Address - Phone:310-480-7129
Mailing Address - Fax:
Practice Address - Street 1:3077 UNIVERSITY AVE STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3717
Practice Address - Country:US
Practice Address - Phone:310-480-7129
Practice Address - Fax:805-584-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-19
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder