Chase Haven

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CHASE HAVEN

Practice address

10610 Pinoak View Dr
Louisville, KY 40299-5840

Phone

(502) 356-4202

NPI assigned

Jun 17, 2024

Organization subpart

No

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

Authorized official

Name

Decora Martin

Title

Program Director

Phone

(502) 475-8958

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1316780562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10610 PINOAK VIEW DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995840",
            "telephone_number": "502-356-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 PINOAK VIEW DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995840",
            "telephone_number": "502-356-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHASE HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-15",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DECORA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "502-475-8958"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.