Provider Demographics
NPI:1699857425
Name:CENTER HAVEN INC
Entity Type:Organization
Organization Name:CENTER HAVEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:GENTRY
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:513-868-9600
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45012-0267
Mailing Address - Country:US
Mailing Address - Phone:513-868-9600
Mailing Address - Fax:513-868-1174
Practice Address - Street 1:422 N 2ND ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-1602
Practice Address - Country:US
Practice Address - Phone:513-868-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6323261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center