Organization Name: | NEWHAVEN |
NPI Number: | 1427388578 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CATHY SHAW (PRESIDENT) |
Mailing Address: | 615 South Hutchinson Avenue Adel |
State: | GA US |
Postal Code: | 31620 |
Phone Number: | 2298967669 |
Fax Number: | 2298969703 |
NPI Enumeration Date: | 01/12/2010 |
NPI Last Update Date: | 01/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 03701005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |