Provider Demographics
NPI:1780494435
Name:HAVEN TREATMENT CENTER - WASHINGTON
Entity type:Organization
Organization Name:HAVEN TREATMENT CENTER - WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-754-9739
Mailing Address - Street 1:2001 AUBURN HILLS PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3571
Mailing Address - Country:US
Mailing Address - Phone:214-754-9739
Mailing Address - Fax:214-548-4159
Practice Address - Street 1:2805 E 19TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4614
Practice Address - Country:US
Practice Address - Phone:564-464-3644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No283Q00000XHospitalsPsychiatric Hospital
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)