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General NPI Number Information
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NPI Number | 1598850364
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Entity Type | Organization
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Legal Business Name | HAVEN OF POSITIVE ENRICHMENT, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/14/2007
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Provider Practice Location Address
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Address Line | 858 HACKNEY AVE
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City | WASHINGTON
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State | NC
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Zip | 27889-4246
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Country | US
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Telephone | 252-946-9427
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Fax | 252-946-9872
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Provider Business Mailing Address
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Address Line | 858 HACKNEY AVE
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City | WASHINGTON
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State | NC
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Zip | 27889-4246
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Country | US
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Telephone | 252-946-9427
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Fax | 252-946-9872
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CEO
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Name | MR. JAMES EDWARD GUILFORD
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Credential | Q.M.H.P.
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Telephone | 252-946-9427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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