Organization
HAVEN DETOX OF WEST MEMPHIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 635-2400
Entity
Organization
Contact information
Practice address
410 S AVALON ST, WEST MEMPHIS, AR 72301-4183
(561) 635-2400
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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