# UNIQUE HAVEN RESIDENTIAL SERVICES LLC

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

## Provider details

- **NPI number:** 1891843009
- **Authorized official:** MRS. ALETHEA MARCELLUS BACHELOR PSYCHOLOGY (CLINICAL CONSULTANT)
- **Authorized official phone:** (919) 306-1469

## Contact information

- **Practice address:** 608 YOUNG ST, CREEDMOOR, NC 27522-8347
- **Practice address phone:** (919) 528-7439
- **Mailing address:** PO BOX 713, CREEDMOOR, NC 27522-0713
- **Mailing address phone:** (919) 528-7439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-039-043 | NC | Yes |

## Other

- **Enumeration date:** 01/07/2007
- **Last updated:** 08/16/2007