Organization
HAVEN MINISTRIES, INC. @ AGAPE
Active
Parent organization
HAVEN MINISTRIES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN MINISTRIES, INC.
Authorized official
DR. DWIGHT HOWARD LYSNE MD, MDIV (DIRECTOR)
(910) 803-1620
Entity
Organization
Contact information
Practice address
3725B WRIGHTSVILLE AVE, WILMINGTON, NC 28403-4140
(910) 803-1620
(215) 902-4882
Mailing address
7212 OYSTER LN, WILMINGTON, NC 28411-7132
(910) 803-1620
(215) 902-4882
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
200301378
NC
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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