Provider Demographics
NPI:1760192892
Name:HANDS ON HAVEN INC.
Entity Type:Organization
Organization Name:HANDS ON HAVEN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:260-804-3908
Mailing Address - Street 1:9517 STOWAWAY CV
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46835-9615
Mailing Address - Country:US
Mailing Address - Phone:260-804-3908
Mailing Address - Fax:
Practice Address - Street 1:4144 WOODHILL DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2976
Practice Address - Country:US
Practice Address - Phone:260-432-0183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty