Provider Demographics
NPI:1124902341
Name:CALM HAVEN LLC
Entity type:Organization
Organization Name:CALM HAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:218-256-2536
Mailing Address - Street 1:7362 UNIVERSITY AVE NE # 31051065
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3142
Mailing Address - Country:US
Mailing Address - Phone:218-256-2536
Mailing Address - Fax:
Practice Address - Street 1:4770 CENTERVILLE RD APT 307
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55127-2312
Practice Address - Country:US
Practice Address - Phone:218-256-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health