Organization · Type 2 NPI
Second Haven Services for Youth Inc.
Emotionally Disturbed Childrens' Residential Treatment Facility · Tobyhanna, PA
Practice location
633 Lakeside Dr
Tobyhanna, PA 18466-9792
Fax (866) 343-5509
Mailing address
PO Box 329
Mount Pocono, PA 18344-0329
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | MD037460L (PA) |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 223180 (PA) |
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | 221370 (PA) |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
About NPI 1053649178
Second Haven Services for Youth Inc.'s National Provider Identifier is 1053649178, issued on Dec 1, 2009. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Tobyhanna, PA. The record was last updated on Feb 9, 2015.