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HAVEN DETOX OF WEST MEMPHIS, LLC
NPI 1043082555
Substance Abuse Rehabilitation Facility in West Memphis, AR

Active since October 27, 2023
410 S AVALON ST, WEST MEMPHIS, AR 72301(561) 635-2400 Get Directions Write a Review

NPPES record last updated: October 27, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Haven Detox Of West Memphis, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAVEN DETOX OF WEST MEMPHIS, LLC (NPI 1043082555) is a healthcare organization registered as a substance abuse rehabilitation facility in West Memphis, Arkansas and active in the NPI registry since October 2023. The organization lists Kirill Vesselov, President, as its authorized official.

NPPES Registry Identity

NPI1043082555
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameHAVEN DETOX OF WEST MEMPHIS, LLC
Location Address410 S AVALON STWest Memphis, AR 72301-4183
Mailing Address2925 10th Ave NPalm Springs, FL 33461-3000
Phone(561) 635-2400
Organization SubpartNo
Authorized OfficialKirill VesselovPresident · (561) 635-2400
Enumeration DateOctober 27, 2023
NPPES CertifiedOctober 27, 2023
✔ NPI 1043082555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A 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.

410 S AVALON ST, West Memphis, AR 72301
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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALF PROPERTIES OF CRITTENDEN COUNTY, LLC
Assisted Living Facility (Assisted Living, Mental Illness)
410 S AVALON ST
WEST MEMPHIS, AR 72301
Crittenden County (870) 732-1878
MR. ALBERT EDWIN JONES LCSW
Social Worker (Clinical)
410 S AVALON ST
WEST MEMPHIS, AR 72301
Crittenden County (870) 394-9577
MR. TERRANCE STAFFORD MHPP
Case Manager/Care Coordinator
410 S AVALON ST, VFW DRIVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 394-9575
MS. PATRICIA HARPER MHPP
Case Manager/Care Coordinator
410 S AVALON ST, VFW DRIVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 394-9575
LINDA K JOHNSON MHPP
Case Manager/Care Coordinator
410 S AVALON ST, VFW DRIVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 394-9575
MR. PATRICK MOODY MHPP
Case Manager/Care Coordinator
410 S AVALON ST, VFW DRIVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 394-9575
MS. JASMINE LOCKHART MHPP
Case Manager/Care Coordinator
410 S AVALON ST, VFW DRIVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 702-7300
MR. JERMAINE HANFOR MHPP
Case Manager/Care Coordinator
410 S AVALON ST, VFW DRIVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 394-9577

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Haven Detox Of West Memphis, LLC's NPI number?

The NPI number for Haven Detox Of West Memphis, LLC is 1043082555. It was assigned to this organization in the NPPES registry on October 27, 2023.

Where is Haven Detox Of West Memphis, LLC located?

Haven Detox Of West Memphis, LLC is located at 410 S Avalon St, West Memphis, AR 72301. The listed phone number is (561) 635-2400.

What is Haven Detox Of West Memphis, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Haven Detox Of West Memphis, LLC was last updated on October 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.