| Davina's Haven LLC | |
|
4405 Jager Dr Ne Ste C4 Rio Rancho NM 87144-5715 | |
| (505) 906-0002 | |
| Not Available |
| Full Name | Davina's Haven LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4405 Jager Dr Ne Ste C4, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Danielray Moises Blea Smith (OWNER/DIRECTOR) |
| Authorized Official Contact | 5059060002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Davina's Haven LLC 4405 Jager Dr Ne Ste C4 Rio Rancho NM 87144-5715 | Davina's Haven LLC 4405 Jager Dr Ne Ste C4 Rio Rancho NM 87144-5715 Ph: (505) 906-0002 |
| NPI Number | 1003623018 |
|---|---|
| Provider Enumeration Date | 12/12/2024 |
| Last Update Date | 02/22/2025 |
| Certification Date | 02/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003623018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
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