Whalio Doctors

NPI 1043858053

Pediatric Haven

Organisation Adolescent and Children Mental Health Clinic/Center Madison, MS

Practice location

Address
102 Lexington Dr, Madison, MS 39110-6952
Phone
(601) 499-6696
Fax
(601) 499-6696
Mailing address
103 Honours Dr, Madison, MS 39110-6513

Authorised official

Name
Jetuwan M. Brown
Title
Managing Partner
Phone
(601) 622-2997

Registered specialties (9)

Adolescent and Children Mental Health Clinic/Center Primary
Ambulatory Health Care Facilities Taxonomy 261QM0855X
Behavior Analyst
Behavioral Health & Social Service Providers Taxonomy 103K00000X
Developmental Disabilities Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center)
Ambulatory Health Care Facilities Taxonomy 261QM0801X
Medically Fragile Infants and Children Day Care
Ambulatory Health Care Facilities Taxonomy 261QM3000X
Pediatric Skilled Nursing Facility
Nursing & Custodial Care Facilities Taxonomy 3140N1450X
Child Mental Illness Respite Care
Respite Care Facility Taxonomy 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care
Respite Care Facility Taxonomy 385HR2060X
Child Physical Disabilities Respite Care
Respite Care Facility Taxonomy 385HR2065X

Registry record

NPI
1043858053
Entity type
Organization
NPI issued
20 Dec 2019
Record last updated
4 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.