HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE COUNTY (NPI# 1942473780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942473780 |
| Entity Type | Organization |
| Organization Name | HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE COUNTY |
| Other Organization Name | HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE CO |
| Practice Address |
548 N Lake Ave Phillips WI 54555 |
| Practice Telephone | 7153396449 |
| Practice Fax Number | 7153396450 |
| Mailing Telephone | 7153396449 |
| Mailing Fax Number | 7153396450 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-10-20 |
| Authorized Official Name | MS. PAMELA MARIE OLSON (CLINICAL COORDINATOR) |
| Authorized Official Telephone | 7153396449 |
| Authorized Official Credential | LICENSED CLINICA |
| Is Organization Subpart | Y |
| Parent Organization Name | HAVEN HOUSE COMMUNITY SUPPORT CENTER OF PRICE COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 753145419 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43429400 | 05 |
| Other Name | Type Code |
|---|---|
| Haven House Community Support Center of Price Co | Former Legal Business Name - Organization |
| Street Address |
548 N LAKE AVE |
| City | PHILLIPS |
| State | WI |
| Zip Code | 54555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477809960 | Kate Strang | Registered Nurse | 548 N Lake Ave, Phillips, WI 54555-1028 | 2012-08-02 |
| 1740564525 | Haven House | Registered Nurse | 548 N Lake Ave, Phillips, WI 54555-1028 | 2011-09-28 |
| 1104121987 | Michael P Sanderson | Counselor | 548 N Lake Ave, Phillips, WI 54555-1028 | 2011-01-25 |
| 1043473606 | Haven House Community Support Center LLC | Community/Behavioral Health | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-07-03 |
| 1285892414 | Pamela Marie Olson | Social Worker | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-05-23 |
| 1609034834 | Michelle J Schmidt | Social Worker | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356971162 | Tully Erwin | Pharmacist | 256 South Lave Avenue, Phillips, WI 54555 | 2020-01-21 |
| 1326494543 | New Horizons North, Inc. | Voluntary or Charitable | 1215 N Airport Rd, Phillips, WI 54555 | 2016-05-06 |
| 1801106265 | Kelly Jean Witt-erickson | Social Worker | 548 North Lake Avenue, Phillips, WI 54555 | 2010-10-19 |
| 1629215314 | Roepke Physical Therapy Limited Partnership | Occupational Therapist | N 9691 Highway 13 N, Phillips, WI 54555 | 2009-01-16 |
| 1598922429 | Counseling & Development Center, Inc | Community/Behavioral Health | 171 Chestnut Street, Phillips, WI 54555 | 2008-05-19 |
| 1518134568 | Central Price Co Ambulance Service, Inc | Ambulance | 104c N Argyle, Phillips, WI 54555 | 2008-05-09 |
| 1235304395 | School District of Phillips | Local Education Agency (LEA) | 365 Highway 100, Phillips, WI 54555 | 2008-04-29 |
| 1295947109 | Northern Sight Vision Clinic, LLC | Optometrist | 104a N. Argyle Ave, Phillips, WI 54555 | 2007-05-04 |
| 1902028541 | County of Price | Public Health or Welfare | 104 S Eyder Avenue, Phillips, WI 54555 | 2007-05-03 |
| 1770703035 | Lori A Severson | Chiropractor | 104-c North Argyle Avenue, Phillips, WI 54555 | 2007-04-27 |
| Find all providers in zip 54555 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598922429 | Counseling & Development Center, Inc | Community/Behavioral Health | 171 Chestnut Street, Phillips, WI 54555 | 2008-05-19 |
| 1881218436 | Serene Counseling, LLC | Community/Behavioral Health | 148 S Avon Ave, Phillips, WI 54555-1308 | 2020-05-29 |
| 1659875375 | County of Price | Community/Behavioral Health | 104 S Eyder Ave, Phillips, WI 54555-1342 | 2018-03-19 |
| 1750529822 | Price County Human Services Dept | Community/Behavioral Health | 104 S Eyder Ave, Phillips, WI 54555-1342 | 2009-01-28 |
| 1538307731 | Price County Human Services Dept | Community/Behavioral Health | 104 S Eyder Ave, Phillips, WI 54555-1342 | 2009-01-26 |
| 1043473606 | Haven House Community Support Center LLC | Community/Behavioral Health | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
| 1437776457 | Milkweed Connections LLC | Community/Behavioral Health | 1700 Tainter St Ste D, Menomonie, WI 54751-1358 | 2020-06-26 |
| 1477178473 | Grace Counseling & Family Services S.c | Community/Behavioral Health | 121 S Adams St, New Lisbon, WI 53950-1205 | 2020-06-15 |
| 1740804491 | Strides Equestrian Therapeutic Center LLC | Community/Behavioral Health | W6769 Colby Factory Rd, Greenwood, WI 54437-9010 | 2020-05-28 |
| 1841831153 | Sheboygan County Halfway House | Community/Behavioral Health | 503 Ontario Ave, Sheboygan, WI 53081-4151 | 2019-10-08 |
| 1780234955 | Spirited Psychological Services LLC | Community/Behavioral Health | 376 Violet Cir, Grantsburg, WI 54840-8564 | 2019-09-18 |
| 1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
| 1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
| 1104386101 | Counseling Center | Community/Behavioral Health | 601 N 5th St, Sheboygan, WI 53081-4624 | 2019-03-25 |
| 1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
| 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.