Provider Demographics
NPI:1811033244
Name:RACHEL'S HAVEN, INC.
Entity Type:Organization
Organization Name:RACHEL'S HAVEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-796-4491
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:POUND
Mailing Address - State:VA
Mailing Address - Zip Code:24279-0148
Mailing Address - Country:US
Mailing Address - Phone:276-796-4491
Mailing Address - Fax:276-796-4491
Practice Address - Street 1:11033 INDIAN CREEK ROAD
Practice Address - Street 2:
Practice Address - City:POUND
Practice Address - State:VA
Practice Address - Zip Code:24279
Practice Address - Country:US
Practice Address - Phone:276-796-4491
Practice Address - Fax:276-796-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA849320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities