Haven Youth Services LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

SS18205 Issued in VA

Legal business name

HAVEN YOUTH SERVICES LLC

Practice address

3122 W Marshall St
Richmond, VA 23230-4726

Phone

(804) 340-5220

Fax

(804) 340-5222

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Darrel Callis

Title

Owner

Phone

(804) 833-2879

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073673869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 W MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304726",
            "telephone_number": "804-340-5220",
            "fax_number": "804-340-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 W MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304726",
            "telephone_number": "804-340-5220",
            "fax_number": "804-340-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN YOUTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CALLIS",
        "authorized_official_first_name": "DARREL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-833-2879",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "SS18205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haus of Herron Supportive Services LLC
• Caitlin Alexandra Hauser, MD
• Kenna Beth Hausler
• Haven Behavioral Health, LLC
• Haven Christian Counseling LLC
• Havencore Consulting LLC
• Andrew Haverly, PT
• Howard O. Haverty, M.D.
• Courtney King Hawkins, LPC
• Nicole Noel Hawkins, MD

• Mental Illness Community Based Residential Treatment Facility in Richmond, VA
• Providers in Richmond, VA by specialty
• Mental Illness Community Based Residential Treatment Facility in Virginia

• 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.