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Organization
BLK HAVEN CORP.
Active
Organization
BLK HAVEN CORP.
Active
Other names
BLK Haven
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEE S WILSON MS, LPCC (CEO/ CO-FOUNDER)
(763) 245-0390
Entity
Organization
Contact information
Practice address
1079 CALLE DECEO, CHULA VISTA, CA 91913-3345
(763) 245-0390
Mailing address
718 KIKANAI LOOP, HONOLULU, HI 96818-4434
(763) 245-0390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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