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Organization

THE EMPRESS HAVEN, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MYISHANKA MCMILLIAN LCMHC (CEO/FOUNDER)
(919) 724-9733
Entity
Organization

Contact information

Practice address
2919 FAYETTEVILLE ST, DURHAM, NC 27707-4175
(919) 724-9733
Mailing address
3 OLIVENE DR, DURHAM, NC 27703-6755
(919) 724-9733

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
252Y00000X
Early Intervention Provider Agency
261Q00000X
Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
320800000X
Mental Illness Community Based Residential Treatment Facility
405300000X
Prevention Professional

Other

Enumeration date
05/26/2022
Last updated
05/26/2022
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