| Haven | |
|
20 S 16th St Wilmington NC 28401-4924 | |
| (910) 399-3927 | |
| (910) 399-3928 |
| Full Name | Haven |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 20 S 16th St, Wilmington, North Carolina |
| Authorized Official Name and Position | Dwight Howard Lysne (MEDICAL DIRECTOR & PASTOR) |
| Authorized Official Contact | 9103993927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven 20 S 16th St Wilmington NC 28401-4924 Ph: (910) 465-1935 | Haven 20 S 16th St Wilmington NC 28401-4924 Ph: (910) 399-3927 |
| NPI Number | 1184055436 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 12/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184055436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 200301378 (North Carolina) | Primary |
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