| Entity Name: | THE HAVEN, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Inactive |
| Date Filed: | 07 Dec 1976 (48 years ago) |
| Document Number: | 737449 |
| FEI/EIN Number | 591708452 |
| Address: | 21441 BOCA RIO ROAD, BOCA RATON, FL, 33433 |
| Mail Address: | 21441 BOCA RIO ROAD, BOCA RATON, FL, 33433 |
| ZIP code: | 33433 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083748164 | 2007-03-14 | 2008-07-10 | 21441 BOCA RIO RD, BOCA RATON, FL, 334332604, US | 21441 BOCA RIO RD, BOCA RATON, FL, 334332604, US | |||||||||||||||||||||||||
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| Phone | +1 561-483-0962 |
| Fax | 5614878007 |
Authorized person
| Name | DONALD STEWART |
| Role | EXECUTIVE DIRECTOR |
| Phone | 5614830962 |
Taxonomy
| Taxonomy Code | 322D00000X - Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | ME0060288 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 360001700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STEWART DON | Agent | 21441 BOCA RIO ROAD, BOCA RATON, FL, 33433 |
| Name | Role | Address |
|---|---|---|
| SMITH THOMAS C | Director | 21441 BOCA RIO ROAD, BOCA RATON, FL, 33433 |
| BERGER SCOTT | Director | 21441 BOCA RIO ROAD, BOCA RATON, FL, 33433 |
| MILEUSNIC MARK | Director | 21441 BOCA RIO ROAD, BOCA RATON, FL, 33433 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2013-02-12 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 2004-12-30 | No data | No data |
| REINSTATEMENT | 1986-01-22 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1984-11-21 | No data | No data |
| AMENDMENT | 1984-07-12 | No data | No data |
| NAME CHANGE AMENDMENT | 1980-11-10 | THE HAVEN, INC. | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
