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Organization
GREEN VALLEY HAVEN, LLC
Active
Organization
GREEN VALLEY HAVEN, LLC
Active
Other names
Green Valley Haven Group Home, Lakeview Care, Wicker Street Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHEA VIVIAN ROGERS (DIRECTOR)
(336) 578-0004
Entity
Organization
Contact information
Practice address
2528 ANDERSON RD, BURLINGTON, NC 27217-9101
(336) 578-0004
(336) 578-0004
Mailing address
PO BOX 981, HAW RIVER, NC 27258-0981
(336) 578-0004
(336) 578-0004
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
10/26/2011
Last updated
04/23/2025
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