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HAVEN DETOX OF NEW JERSEY LLC
NPI 1255113569
Substance Abuse Rehabilitation Facility in Blackwood, NJ

Active since October 20, 2023
6 COLLIER DR, BLACKWOOD, NJ 08012(561) 635-2400 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 8, 2024, Oct 20, 2023 (2 updates tracked since 2023).

About Haven Detox Of New Jersey Llc NPPES

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

HAVEN DETOX OF NEW JERSEY LLC (NPI 1255113569) is a healthcare organization registered as a substance abuse rehabilitation facility in Blackwood, New Jersey and active in the NPI registry since October 2023. The organization lists Kirill Vesselov, President, as its authorized official.

NPPES Registry Identity

NPI1255113569
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameHAVEN DETOX OF NEW JERSEY LLC
Location Address6 COLLIER DRBlackwood, NJ 08012-2983
Mailing Address2925 10th Ave NPalm Springs, FL 33461-3000
Phone(561) 635-2400
Organization SubpartNo
Authorized OfficialKirill VesselovPresident · (561) 396-5849
Enumeration DateOctober 20, 2023
Last NPPES UpdateJanuary 15, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2025
✔ NPI 1255113569 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.
6 COLLIER DR, Blackwood, NJ 08012
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Other Providers at the Same Location NPPES 3

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

GERALD J DURIVAGE APN
Nurse Practitioner (Family)
6 COLLIER DR
BLACKWOOD, NJ 08012
Camden County (610) 908-9811
MRS. CYNTHIA A. MENZONI APN-BC
Nurse Practitioner (Adult Health)
6 COLLIER DR
BLACKWOOD, NJ 08012
Camden County (856) 677-5226
HAVEN DETOX NJ OPERATING SUBSIDIARY, LLC
Substance Abuse Rehabilitation Facility
6 COLLIER DR
BLACKWOOD, NJ 08012
Camden County (856) 856-2883

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 New Jersey LLC's NPI number?

The NPI number for Haven Detox Of New Jersey LLC is 1255113569. It was assigned to this organization in the NPPES registry on October 20, 2023.

Where is Haven Detox Of New Jersey LLC located?

Haven Detox Of New Jersey LLC is located at 6 Collier Dr, Blackwood, NJ 08012. The listed phone number is (561) 635-2400.

What is Haven Detox Of New Jersey 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 New Jersey LLC was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.