Provider Demographics
NPI:1033957733
Name:HEART S HAVEN LLC
Entity type:Organization
Organization Name:HEART S HAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUTROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-665-3892
Mailing Address - Street 1:94 HANCOCK AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2116
Mailing Address - Country:US
Mailing Address - Phone:201-665-3892
Mailing Address - Fax:
Practice Address - Street 1:94 HANCOCK AVE APT 1
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2116
Practice Address - Country:US
Practice Address - Phone:201-665-3892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty