Organization
BETHEL HAVEN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE BRANTLEY (EXECUTIVE DIRECTOR)
(706) 310-9046
Entity
Organization
Contact information
Practice address
1030 VILLAGE DR STE B, WATKINSVILLE, GA 30677-6004
(706) 310-9076
Mailing address
1030 VILLAGE DR STE B, WATKINSVILLE, GA 30677-6004
(706) 310-9076
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
APC005174
GA
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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