Provider Demographics
NPI:1225873615
Name:HAVEN ROOM THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:HAVEN ROOM THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:HOPSON
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-776-4626
Mailing Address - Street 1:28210 PASEO DRIVE, SUITE 190
Mailing Address - Street 2:OFFICE 232
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-3753
Mailing Address - Country:US
Mailing Address - Phone:147-776-4626
Mailing Address - Fax:813-336-8404
Practice Address - Street 1:28210 PASEO DRIVE, SUITE 190
Practice Address - Street 2:OFFICE 232
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-3753
Practice Address - Country:US
Practice Address - Phone:147-776-4626
Practice Address - Fax:813-336-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty