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SECOND HAVEN SERVICES FOR YOUTH INC. NPI 1053649178


NPI Information

NPI: 1053649178
Provider Name: SECOND HAVEN SERVICES FOR YOUTH INC.

Doing Business As: ROSE RESILIENCY CENTER

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
633 LAKESIDE DR
TOBYHANNA, PA
ZIP 18466
Phone: (866) 343-5509
Get Directions

SECOND HAVEN SERVICES FOR YOUTH INC. is a residential treatment facility emotionally disturbed children in Tobyhanna, PA. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. SECOND HAVEN SERVICES FOR YOUTH INC. NPI is 1053649178. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Rose Resiliency Center.

The provider's business location address is:

633 LAKESIDE DR
TOBYHANNA, PA
ZIP 18466-792
Phone: (866) 343-5509
Fax: (866) 343-5509

The provider's authorized official is William Freeman .
The authorized official title is Executive Director and has the following contact phone number (866) 343-5509.

The enumeration date for this NPI number is 12/1/2009 and was last updated on 2/9/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TP0016XPsychologistPrescribing (Medical)MD037460LPENNSYLVANIANo
2320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities223180PENNSYLVANIANo
3322D00000XResidential Treatment Facility, Emotionally Disturbed Children221370PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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