# J4 STABILITY & SAFE HAVEN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467143883
- **Authorized official:** SHADAE T WILLIAMS LCSWA LCASA CADC (OWNER/ CEO)
- **Authorized official phone:** (336) 749-5267

## Contact information

- **Practice address:** 1308 N INDEPENDENCE ST, KINSTON, NC 28501-2908
- **Practice address phone:** (336) 749-5267
- **Mailing address:** 6201 MAURICE CIR, RURAL HALL, NC 27045-9734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | — | — |

## Other

- **Enumeration date:** 05/17/2023
- **Last updated:** 05/17/2023