National Provider Identifier Database

HAVEN DETOX MA
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.


Contact Information

HAVEN DETOX MA
1369 GRAFTON ST
WORCESTER, MA01604-2737
Phone: 508-552-3180
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X
Adult Mental Health 261QM0850X
Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for HAVEN DETOX MA

NPI Number 1770159105
Legal business name
LBN
HAVEN DETOX MA
Authorized official JOHN MARONEY - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 05/27/2021
Last updated 11/28/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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