Provider Demographics
NPI:1740452283
Name:YOUTH HAVEN INC
Entity type:Organization
Organization Name:YOUTH HAVEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCSWINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-774-2904
Mailing Address - Street 1:5867 WHITAKER ROAD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112
Mailing Address - Country:US
Mailing Address - Phone:239-774-2904
Mailing Address - Fax:239-774-0801
Practice Address - Street 1:5867 WHITAKER ROAD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112
Practice Address - Country:US
Practice Address - Phone:239-774-2904
Practice Address - Fax:239-774-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health