OrganizationActive
A Willow Haven
NPI 1447912175 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hazard, KY
Provider details
- NPI number
- 1447912175
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jory Wells, Executive Director(606) 505-7300
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
400 Elizabeth Dr
Hazard, KY 41701-1228
Phone: (606) 505-7300
Approximate (ZIP-level) locationGet directions
Mailing address
400 Elizabeth Dr
Hazard, KY 41701-1228
Registry dates
- Enumerated
- 2021-10-11
- Last updated
- 2021-10-11
- Certified
- 2021-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.