# GREEN VALLEY HAVEN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Green Valley Haven Group Home, Lakeview Care, Wicker Street Group Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164708897
- **Authorized official:** DOROTHEA VIVIAN ROGERS (DIRECTOR)
- **Authorized official phone:** (336) 578-0004

## Contact information

- **Practice address:** 2528 ANDERSON RD, BURLINGTON, NC 27217-9101
- **Practice address phone:** (336) 578-0004
- **Practice address fax:** (336) 578-0004
- **Mailing address:** PO BOX 981, HAW RIVER, NC 27258-0981
- **Mailing address phone:** (336) 578-0004
- **Mailing address fax:** (336) 578-0004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/26/2011
- **Last updated:** 04/23/2025