Haven Behavioral Services of Pueblo, LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

01P254 Issued in CO

Legal business name

HAVEN BEHAVIORAL SERVICES OF PUEBLO, LLC

Practice address

1008 Minnequa Ave
Suite 6100
Pueblo, CO 81004-3733

Phone

(719) 546-6000

Fax

(719) 565-4021

NPI assigned

May 10, 2007

Organization subpart

Yes

Parent organization

HAVEN BEHAVIORAL HEALTHCARE INC.As reported in NPPES

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

Authorized official

Name

Christy A Keltner

Title

Avp / Revenue Cycle

Phone

(615) 393-8816

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Haven Behavioral Hospital of Southern Colorado Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 064025

Legal name

HAVEN BEHAVIORAL HOSPITAL OF SOUTHERN COLO

Certification status

Terminated Voluntary: merger or closure, Feb 1, 2016

Provider type (POS)

Hospital – Psychiatric

Participating since

May 20, 2008

Last certification

Mar 2, 2012

Beds

30

Ownership / control type

Private (not for profit)

Facility address

1008 Minnequa Avenue Suite 6100
Pueblo, CO 81004

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Haven Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1871969691
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harry D Silsby, MD

  • Psychiatry Physician
  • Santa Teresa, NM
  • NPI 1043249428
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1487868170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "address_2": "SUITE 6100",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-546-6000",
            "fax_number": "719-565-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "address_2": "SUITE 6100",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-546-6000",
            "fax_number": "719-565-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN BEHAVIORAL SERVICES OF PUEBLO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVEN BEHAVIORAL HEALTHCARE INC.",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "KELTNER",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AVP / REVENUE CYCLE",
        "authorized_official_telephone_number": "615-393-8816"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CO",
            "license": "APPLIED FOR",
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CO",
            "license": "01P254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A",
            "identifier": "064025",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Behavioral Hospital of Southern Colorado",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathaniel Hasbrouck, CRNA
• Amanda Hasenack
• Taimoor NA Hassan
• Meagan Leigh Hastie
• Gregory J Haubrich, PAC
• Jean R Haver, LCSW
• Jeonghye Hawes, RPH
• Allison C Hawkins, M.A., CCC-SLP
• Matthew Hawkins, B.S.
• Hawthorne Mental Health LLC

• Psychiatric Hospital in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Psychiatric Hospital in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.