Provider Demographics
NPI:1598046492
Name:CHRISTIAN HAVEN, INC.
Entity Type:Organization
Organization Name:CHRISTIAN HAVEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OATIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-956-3125
Mailing Address - Street 1:12501 N STATE ROAD 49
Mailing Address - Street 2:
Mailing Address - City:WHEATFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46392-8986
Mailing Address - Country:US
Mailing Address - Phone:219-956-3125
Mailing Address - Fax:
Practice Address - Street 1:12501 N STATE ROAD 49
Practice Address - Street 2:
Practice Address - City:WHEATFIELD
Practice Address - State:IN
Practice Address - Zip Code:46392-8986
Practice Address - Country:US
Practice Address - Phone:219-956-3125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty