Haven Developmental Care

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

CLA000738 Issued in GA

Legal business name

HAVEN DEVELOPMENTAL CARE

Practice address

4794 Michael Jay St
Snellville, GA 30039-7630

Phone

(770) 761-3402

Fax

(770) 679-4561

NPI assigned

Sep 28, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Carol Agatha Trim-Bagot, MA

Title

Director/Ceo

Phone

(770) 761-3402

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1902189723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4794 MICHAEL JAY ST",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397630",
            "telephone_number": "770-761-3402",
            "fax_number": "770-679-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4794 MICHAEL JAY ST",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397630",
            "telephone_number": "770-761-3402",
            "fax_number": "770-679-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN DEVELOPMENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "TRIM-BAGOT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "AGATHA",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "770-761-3402",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "CLA000738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Amaris Harrison, MS
• London Christy Harroff, B.S., D.C.
• Sheri Miranda Hart
• Gloria A. Hatney, OTR
• Hattie'S Nursing Hands, Inc.
• Haven Hospice and Palliative Care of Georgia, LLC
• Roger Charlton Hawes, D.C.
• Cynthia D Hawkins, MT005449
• Calvin Hayes
• Charlotte A Hayes, MD

• Community/Behavioral Health Agency in Snellville, GA
• Providers in Snellville, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.