Pediatric Haven
NPI 1043858053 · Adolescent and Children Mental Health Clinic/Center · Madison, MS
Pediatric Haven is a Adolescent and Children Mental Health Clinic/Center organization in Madison, MS (NPI 1043858053).
Provider details
- NPI number
- 1043858053
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jetuwan Brown, Managing Partner(601) 622-2997
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- Pediatric Skilled Nursing Facility3140N1450X
Nursing & Custodial Care Facilities
- Behavior Analyst103K00000X
Behavioral Health & Social Service Providers
- Developmental Disabilities Clinic/Center261QD1600X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Pediatric Haven Autism Center
Registry dates
- Enumerated
- 2019-12-20
- Last updated
- 2024-01-04
- Certified
- 2024-01-04
Frequently asked questions
- What is Pediatric Haven's NPI number?
- Pediatric Haven's National Provider Identifier (NPI) is 1043858053, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pediatric Haven?
- Pediatric Haven is classified in the NPPES registry as Adolescent and Children Mental Health Clinic/Center (Ambulatory Health Care Facilities).
- Where is Pediatric Haven located?
- Pediatric Haven's practice location on file with NPPES is 102 Lexington Dr, Madison, MS 39110-6952.
- What is Pediatric Haven's phone number?
- The practice phone number listed in the NPPES registry for Pediatric Haven is (601) 499-6696.
- Who is the authorized official for Pediatric Haven?
- The authorized official listed on Pediatric Haven's NPPES record is Jetuwan Brown, Managing Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pediatric Haven's NPI active?
- Yes — Pediatric Haven's NPI (1043858053) is active in the NPPES registry as of the last update on 2024-01-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.