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Organization
UNIQUE HAVEN RESIDENTIAL SERVICES LLC
Active
Organization
UNIQUE HAVEN RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALETHEA MARCELLUS BACHELOR PSYCHOLOGY (CLINICAL CONSULTANT)
(919) 306-1469
Entity
Organization
Contact information
Practice address
608 YOUNG ST, CREEDMOOR, NC 27522-8347
(919) 528-7439
Mailing address
PO BOX 713, CREEDMOOR, NC 27522-0713
(919) 528-7439
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-039-043
NC
Other
Enumeration date
01/07/2007
Last updated
08/16/2007
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