Organization Name: | HAVEN YOUTH AND FAMILY SERVICES |
NPI Number: | 1164864302 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLEY SMITH (DIRECTOR) |
Mailing Address: | 825 Green Bay Rd Suite 200 Wilmette |
State: | IL US |
Postal Code: | 600912597 |
Phone Number: | 8472516630 |
Fax Number: | 8155211889 |
NPI Enumeration Date: | 07/29/2013 |
NPI Last Update Date: | 07/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |