HAVEN DETOX MA LLC NPI 1770159105

NPI Information

HAVEN DETOX MA, LLC is a substance abuse rehabilitation facility in Worcester, MA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. HAVEN DETOX MA, LLC NPI is 1770159105. The provider is registered as an organization entity type.

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 with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2021 and was last updated on 9/27/2021.

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:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.