Hettie'S Haven,LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Coeburn, VA
NPI 1740705177 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1740705177
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- 2839-01-001 (VA)
- Legal business name
- HETTIE'S HAVEN,LLC
- Practice address
- 12108 Retford Rd
Coeburn, VA 24230-5910 - Phone
- (276) 393-2530
- NPI assigned
- Aug 7, 2017
- Organization subpart
- No
Authorized official
- Name
- Ms. Terri Ann Tuck
- Title
- Consultant
- Phone
- (540) 586-4023
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 2839-01-001 | VA | Yes |
Addresses
Primary practice location
12108 Retford Rd
Coeburn, VA 24230-5910
Mailing address
12108 Retford Rd
Coeburn, VA 24230-5910
Phone (276) 393-2530
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All providers in Coeburn, VA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.