Provider Demographics
NPI:1366719866
Name:A HAVEN FOR KIDS, INC.
Entity type:Organization
Organization Name:A HAVEN FOR KIDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MED
Authorized Official - Phone:513-777-2428
Mailing Address - Street 1:7140 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2261
Mailing Address - Country:US
Mailing Address - Phone:513-777-2428
Mailing Address - Fax:
Practice Address - Street 1:5900 W CHESTER RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2951
Practice Address - Country:US
Practice Address - Phone:513-777-2428
Practice Address - Fax:513-777-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 143041251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0067203Medicaid