The Haven Halfway House, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1044351 Issued in MN

Legal business name

THE HAVEN HALFWAY HOUSE, LLC

Practice address

32524 Meadow LN
Saint Joseph, MN 56374-9760

Phone

(320) 202-7881

NPI assigned

Jun 13, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas Russell Austad, LADC

Title

Chief Executive Officer

Phone

(320) 293-3418

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003010125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32524 MEADOW LN",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563749760",
            "telephone_number": "320-293-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32524 MEADOW LN",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563749760",
            "telephone_number": "320-202-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HAVEN HALFWAY HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AUSTAD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "320-293-3418",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1044351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Saint Joseph, MN
• Providers in Saint Joseph, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.