A Willow Haven

Primary specialty

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

Legal business name

A WILLOW HAVEN

Practice address

400 Elizabeth Dr
Hazard, KY 41701-1228

Phone

(606) 505-7300

NPI assigned

Oct 11, 2021

Last updated

Oct 11, 2021By 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. Jory Wells

Title

Executive Director

Phone

(606) 505-7300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1447912175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ELIZABETH DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417011228",
            "telephone_number": "606-505-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ELIZABETH DR",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417011228",
            "telephone_number": "606-505-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A WILLOW HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "JORY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "606-505-7300",
        "authorized_official_name_prefix": "Mr."
    },
    "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": []
}

• A Bright Future, LLC
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• Abilities Advancement
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• Bianca Absher, APRN
• Ace Clinique of Medicine

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Hazard, KY
• Providers in Hazard, 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 Oct 11, 2021; 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.