NPIMap

Organization Active NPI

Haven House, Inc .

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Elkton, MD
National Provider Identifier
1699503185
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HAVEN HOUSE, INC .
Practice address
1195 Augustine Herman Hwy
Elkton, MD 21921-8252
Phone
(410) 398-9900
NPI assigned
Jul 25, 2024
Organization subpart
Yes
Parent organization
HAVEN HOUSE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Jessie Costley
Title
Credentialing Specialist
Phone
(443) 839-6928

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

1195 Augustine Herman Hwy
Elkton, MD 21921-8252

Mailing address

1195 Augustine Herman Hwy
Elkton, MD 21921-8252

National Provider Directory

National Provider Directory
Tax ID family
Haven House Inc2 organizations share this tax ID, including this one
Part of
Haven House Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1699503185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 AUGUSTINE HERMAN HWY",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219218252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 AUGUSTINE HERMAN HWY",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219218252",
            "telephone_number": "410-398-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN HOUSE, INC .",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVEN HOUSE, INC",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "COSTLEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "443-839-6928"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.