Provider Demographics
NPI:1811194285
Name:HAVEN HOUSE INC.
Entity Type:Organization
Organization Name:HAVEN HOUSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-833-3312
Mailing Address - Street 1:600 W CABARRUS ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1953
Mailing Address - Country:US
Mailing Address - Phone:919-833-3312
Mailing Address - Fax:919-833-3512
Practice Address - Street 1:600 W CABARRUS ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1953
Practice Address - Country:US
Practice Address - Phone:919-833-3312
Practice Address - Fax:919-833-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005518Medicaid
NC8301281Medicaid