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Organization
HAVEN MINISTRIES, INC.
Active
Organization
HAVEN MINISTRIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT LYSNE M.D., M.DIV. (DIRECTOR)
(910) 803-1620
Entity
Organization
Contact information
Practice address
400 FLEMINGTON DRIVE, LAKE WACCAMAW, NC 28450-2512
(910) 803-1620
(484) 315-2387
Mailing address
7212 OYSTER LN, WILMINGTON, NC 28411-7132
(910) 803-1620
(484) 315-2387
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
200301378
NC
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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