THE HAVEN HALFWAY HOUSE, LLC NPI 1003010125

Substance Abuse Rehabilitation Facility in Saint Joseph, MN

NPI 1003010125 Organization Substance Abuse Rehabilitation Facility

About THE HAVEN HALFWAY HOUSE, LLC

The Haven Halfway House, Llc is a provider established in Saint Joseph, Minnesota specializing in substance abuse rehabilitation facility. The NPI number of The Haven Halfway House, Llc is 1003010125 and was assigned on June 2007. The practitioner's primary taxonomy code is 324500000X with license number 1044351 (MN). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Thomas Russell Austad Ladc (Chief Executive Officer)

NPI

1003010125

Provider NameTHE HAVEN HALFWAY HOUSE, LLC
Provider Location Address32524 MEADOW LN SAINT JOSEPH, MN 56374
Provider Mailing Address32524 MEADOW LN SAINT JOSEPH, MN 56374
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date06-13-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code324500000X
ClassificationSubstance Abuse Rehabilitation Facility
TypeResidential Treatment Facilities
License No.1044351
License StateMN
Taxonomy DescriptionA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Business Address

THE HAVEN HALFWAY HOUSE, LLC
32524 MEADOW LN
SAINT JOSEPH, MN
ZIP 56374
Phone: (320) 202-7881

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Mailing Address

THE HAVEN HALFWAY HOUSE, LLC
32524 MEADOW LN
SAINT JOSEPH, MN
ZIP 56374
Phone: (320) 293-3418



Authorized Official

Authorized Official NameMR. THOMAS RUSSELL AUSTAD LADC
Authorized Official TitleCHIEF EXECUTIVE OFFICER
Authorized Official Phone(320) 293-3418

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.