Organization Active NPI

Dehaven Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Hazlehurst, GA
National Provider Identifier
1134308562
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DEHAVEN HEALTHCARE, INC.
Practice address
121 Ray Rd
Hazlehurst, GA 31539-5119
Phone
(888) 782-1138
Fax
(912) 525-3183
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Mr. Robert W. Dehaven, LPC, NCC, DAPA
Title
President & Ceo
Phone
(888) 782-1138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

121 Ray Rd
Hazlehurst, GA 31539-5119

Mailing address

131 Ray Rd
Hazlehurst, GA 31539-5119
Phone (888) 782-1138

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1134308562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 RAY RD",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315395119",
            "telephone_number": "888-782-1138",
            "fax_number": "912-525-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 RAY RD",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315395119",
            "telephone_number": "888-782-1138",
            "fax_number": "912-525-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEHAVEN HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "DEHAVEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "888-782-1138",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC, NCC, DAPA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.