Unique Haven Residential Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-039-043 Issued in NC

Legal business name

UNIQUE HAVEN RESIDENTIAL SERVICES LLC

Practice address

608 Young St
Creedmoor, NC 27522-8347

Phone

(919) 528-7439

NPI assigned

Jan 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Alethea Marcellus, BACHELOR PSYCHOLOGY

Title

Clinical Consultant

Phone

(919) 306-1469

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Unique Haven Residential Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Unique Haven Residential Services LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Creedmoor, NC
  • NPI 1841488400
  NPD tax ID

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

{
    "created_epoch": "1168128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1891843009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275220713",
            "telephone_number": "919-528-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 YOUNG ST",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275228347",
            "telephone_number": "919-528-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIQUE HAVEN RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-07",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "MARCELLUS",
        "authorized_official_first_name": "ALETHEA",
        "authorized_official_title_or_position": "CLINICAL CONSULTANT",
        "authorized_official_telephone_number": "919-306-1469",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BACHELOR PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-039-043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805713",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Traub, LCAS, LPC
• Triangle Advanced Diagnostic Imaging.
• Trusted Hands Home Care Agency LLC
• Lindsey Marie Turner, PHARMD, RPH
• Unique Haven Residential Services LLC
• Wake Care LLC
• Walgreen Co
• Walgreen Co
• Warrick Stewart Community Resource Solutions
• Warrick Stewart Community Resource Solutions, LLC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Creedmoor, NC
• Providers in Creedmoor, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.