HAVEN DETOX MA NPI 1770159105

NPI Information

  • NPI: 1770159105
  • Provider Name: HAVEN DETOX MA
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • Doing Business As: THE HAVEN NEW ENGLAND
  • CLIA Number: 22D2225560
  • Address: 1369 GRAFTON ST
    WORCESTER, MA
    ZIP 01604
  • Phone: (508) 552-3180

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NPI Details

HAVEN DETOX MA is a community based residential treatment facility mental illness in Worcester, MA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. HAVEN DETOX MA NPI is 1770159105. The provider is registered as an organization entity type.
The provider Is Doing Business As The Haven New England.

The provider's business location address is:

1369 GRAFTON ST
WORCESTER, MA
ZIP 01604-737
Phone: (508) 552-3180

The provider's authorized official is John Maroney .
The authorized official title is Manager and has the following contact phone number (508) 552-3180.

The CLIA number assigned to this NPI record is 22D2225560 - other - detox(substance abuse) with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2021 and was last updated on 11/28/2023.

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
1261QM0850XClinic/CenterAdult Mental HealthNo
2324500000XSubstance Abuse Rehabilitation FacilityNo
3320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

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: 11/21/2025

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