Provider Demographics
NPI:1700202306
Name:THE HAVEN OF HARLEM
Entity Type:Organization
Organization Name:THE HAVEN OF HARLEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-556-9933
Mailing Address - Street 1:285 FAIRVIEW DR
Mailing Address - Street 2:PO BOX 969
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-5096
Mailing Address - Country:US
Mailing Address - Phone:706-556-9933
Mailing Address - Fax:706-556-9953
Practice Address - Street 1:285 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:HARLEM
Practice Address - State:GA
Practice Address - Zip Code:30814-5096
Practice Address - Country:US
Practice Address - Phone:706-556-9933
Practice Address - Fax:706-556-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care