Provider Demographics
NPI:1144662941
Name:ONE HAVEN
Entity type:Organization
Organization Name:ONE HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-355-3554
Mailing Address - Street 1:160 S 1000 E
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1428
Mailing Address - Country:US
Mailing Address - Phone:801-355-3554
Mailing Address - Fax:801-355-3711
Practice Address - Street 1:160 S 1000 E
Practice Address - Street 2:SUITE 210
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1428
Practice Address - Country:US
Practice Address - Phone:801-355-3554
Practice Address - Fax:801-355-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty