Healthcare Provider Details

I. General information

NPI: 1538023577
Provider Name (Legal Business Name): CARE HAVEN COLLECTIVE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N SMITHFIELD RD
KNIGHTDALE NC
27545-7721
US

IV. Provider business mailing address

2001 WIDEWATERS PKWY STE A
KNIGHTDALE NC
27545-7324
US

V. Phone/Fax

Practice location:
  • Phone: 919-984-5004
  • Fax:
Mailing address:
  • Phone: 919-984-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAMIKA GARNER
Title or Position: OWNER
Credential:
Phone: 919-827-5432