THE HAVEN DETOX CENTER LLC (NPI# 1073995080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073995080 |
| Entity Type | Organization |
| Organization Name | THE HAVEN DETOX CENTER LLC |
| Practice Address |
8649 Martin Way E Lacey WA 98516-5812 |
| Practice Telephone | 3605150422 |
| Practice Fax Number | 9287089620 |
| Mailing Telephone | 3605150422 |
| Mailing Fax Number | 9287089620 |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |
| Authorized Official Name | KATIE LAGER (OFFICE DIRECTOR) |
| Authorized Official Telephone | 3605150422 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | RTF.FS.60577277 | WA | Residential Treatment Facilities |
| Street Address |
8649 MARTIN WAY E |
| City | LACEY |
| State | WA |
| Zip Code | 98516-5812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023646882 | Chhorn Houn Pho | Rehabilitation Practitioner | 8649 Martin Way E, Lacey, WA 98516-5812 | 2020-03-28 |
| 1467807727 | Royal Life Centers, LLC | Substance Abuse Rehabilitation Facility | 8649 Martin Way E, Lacey, WA 98516-5812 | 2016-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730744210 | Michael Oropeza | Behavioral Analyst | 8282 28th Court Northeast, Suite A, Lacey, WA 98516 | 2019-05-09 |
| 1902361330 | Amanda Jessica Mae Allen | Behavioral Analyst | Basics Nw LLC, 8282 28th Ct Ne Suite A, Lacey, WA 98516 | 2019-02-11 |
| 1619459393 | Kayla-renee Williams | Behavioral Analyst | Basics Nw LLC 8282 28th Ct Ne, Suite A, Lacey, WA 98516 | 2018-08-30 |
| 1174004303 | Julie Ann Lisowski | Massage Therapist | 3532 Cuddy Ln Ne, Lacey, WA 98516 | 2018-08-26 |
| 1740700145 | Joseph Brandon Kimmel | Denturist | 5032 Beverly Dr Ne, Olympia, WA 98516 | 2017-06-27 |
| 1649649880 | Katie Cole | Behavioral Analyst | 8282 28th Ct Ne, Suite A, Basics Nw, LLC, Lacey, WA 98516 | 2015-09-17 |
| 1306234166 | Reza Tahernia | Dentist | 8050 Freedon Lane Ne, Suite C, Lacey, WA 98516 | 2015-01-02 |
| 1770997603 | Qualified Surgical Services Pllc | Surgery | 3697 Cameron Dr Ne, Lacey, WA 98516 | 2014-06-18 |
| 1184048688 | Stephanie Renee Hjortedal | Specialist/Technologist | 8750 Tallon Lane Ne., Lacey, WA 98516 | 2014-02-05 |
| 1295169811 | Teasha Corrado | Behavioral Analyst | 8282 28th Court Ne, Suite A, Lacey, WA 98516 | 2013-08-30 |
| Find all providers in zip 98516 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467807727 | Royal Life Centers, LLC | Substance Abuse Rehabilitation Facility | 8649 Martin Way E, Lacey, WA 98516-5812 | 2016-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787763 | For The Culture Counseling Services | Substance Abuse Rehabilitation Facility | 4301 S Pine St Ste 92, Tacoma, WA 98409-7259 | 2020-10-12 |
| 1760090518 | Hotel California By The Sea Bellevue, LLC. | Substance Abuse Rehabilitation Facility | 7810 130th Ave Ne, Kirkland, WA 98033-8251 | 2020-07-17 |
| 1629532569 | Sandra Ann Moore | Substance Abuse Rehabilitation Facility | 2632 E 17th St, Bremerton, WA 98310-5058 | 2019-01-24 |
| 1972085835 | Peninsula Counseling, LLC | Substance Abuse Rehabilitation Facility | 3214 50th Street Ct Nw Ste D-305, Gig Harbor, WA 98335-8589 | 2018-09-06 |
| 1356831911 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 44 E Cozza Dr Ste B, Spokane, WA 99208-6514 | 2018-05-18 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1023515400 | Evergreen Recovery Centers | Substance Abuse Rehabilitation Facility | 1905 Continental Place, Mount Vernon, WA 98273 | 2018-04-11 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1346785524 | Big Change Medical | Substance Abuse Rehabilitation Facility | 26857 16th Ave S, Des Moines, WA 98198-9327 | 2016-12-27 |
| 1881062362 | Sea-mar Community Health Center | Substance Abuse Rehabilitation Facility | 113 23rd Ave S, Seattle, WA 98144-2309 | 2015-09-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.