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GRACE HAVEN MANAGEMENT INC. NPI 1134130909


NPI Information

NPI: 1134130909
Provider Name: GRACE HAVEN MANAGEMENT, INC.

Doing Business As: GRACE HAVEN HOUSE

Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
6111 MAGAZINE DR
MECHANICSVILLE, VA
ZIP 23111
Phone: (804) 779-2356
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GRACE HAVEN MANAGEMENT, INC. is a counselor in Mechanicsville, VA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. GRACE HAVEN MANAGEMENT, INC. NPI is 1134130909. The provider is registered as an organization entity type.
The provider Is Doing Business As Grace Haven House.

The provider's business location address is:

6111 MAGAZINE DR
MECHANICSVILLE, VA
ZIP 23111-540
Phone: (804) 779-2356
Fax: (804) 779-7566

The provider's authorized official is Karlyn Clevert Smith .
The authorized official title is Cao/program Director and has the following contact phone number (804) 779-2356.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 9/19/2008.


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
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessSS-269-06VIRGINIANo
2101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1010217245MEDICAIDVIRGINIA

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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