BLK HAVEN CORP. NPI 1184322455

NPI Information

NPI: 1184322455
Provider Name: BLK HAVEN CORP.
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1633 KARSYN LN
LITHIA SPRINGS, GA
ZIP 30122
Phone: (619) 330-5601
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BLK HAVEN CORP. is a mental health counselor in Lithia Springs, GA. BLK HAVEN CORP. NPI is 1184322455. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1633 KARSYN LN
LITHIA SPRINGS, GA
ZIP 30122-970
Phone: (619) 330-5601

The provider's authorized official is Ashlee S Wilson .
The authorized official title is Ceo and has the following contact phone number (763) 245-0390.

The enumeration date for this NPI number is 2/16/2023 and was last updated on 2/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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