Grace Haven House

LBN: Grace Haven Management, Inc.
Grace Haven House is an health care organization with primary practice located at 6111 Magazine Dr , Mechanicsville VA 23111-4540. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness. Behavioral Health & Social Service Providers / Counselor is the primary health care specialty. Grace Haven Management, Inc. can be contacted via phone (804) 779-2356, or through Smith, Karlyn Clevert via phone (804) 779-2356.

Contact Information

Primary practice address
6111 Magazine Dr Mechanicsville VA 23111-4540
Phone: (804) 779-2356
Fax: (804) 779-7566
Website:
Map and Directions
Authorized official contact:
Name: Smith, Karlyn Clevert
Phone: (804) 779-2356

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X SS-269-06 Virginia

Profile Details

NPI number 1134130909
LBN Legal business name Grace Haven Management, Inc.
DBA Doing business as Grace Haven House
Authorized official Smith, Karlyn Clevert
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Sep 19th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134130909 NPPES
Virginia MEDICAID 010217245

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