Hettie's Haven,llc

NPI #1740705177 in Coeburn, Virginia

Provider Information

NPI Number: 1740705177
Entity Type: Organization
Organization Name: Hettie's Haven,llc
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 7, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 12108 RETFORD RD
City: Coeburn
State: Virginia
ZIP Code: 24230-5910
Phone: (276) 393-2530

Authorized Official

Name: MS. TERRI ANN TUCK
Title: CONSULTANT
Phone: (540) 586-4023

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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