NPIMap

Organization Active NPI

Haven Chemical Health Systems, LLC

Doing business as Rebecca Residence Scandia

  • Addiction (Substance Use Disorder) Counselor
  • Scandia, MN
National Provider Identifier
1952464547
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1024597-1-CDT Issued in MN
Legal business name
HAVEN CHEMICAL HEALTH SYSTEMS, LLC
Doing business as
Rebecca Residence Scandia
Practice address
21077 Penrose Ave N
Scandia, MN 55073-9710
Phone
(651) 433-5839
Fax
(651) 433-5921
NPI assigned
Dec 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert Haven
Title
President
Phone
(651) 734-9633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1024597-1-CDT MN Primary

Addresses

Primary practice location

21077 Penrose Ave N
Scandia, MN 55073-9710

Mailing address

2042 Wooddale Dr
Suite 220
Woodbury, MN 55125-2981
Phone (651) 734-9633

Other names 1

  • Rebecca Residence Scandia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Haven Chemical Health Systems LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2042 Wooddale Dr
Ste 220
Woodbury, MN 55125
Phone (651) 734-9633

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952464547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 WOODDALE DR",
            "address_2": "SUITE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252981",
            "telephone_number": "651-734-9633",
            "fax_number": "651-734-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21077 PENROSE AVE N",
            "city": "SCANDIA",
            "state": "MN",
            "postal_code": "550739710",
            "telephone_number": "651-433-5839",
            "fax_number": "651-433-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN CHEMICAL HEALTH SYSTEMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAVEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-734-9633"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1024597-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebecca Residence Scandia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scandia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.