Organization
BLISS HAVEN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHEENA S (CEO/EXECUTIVE DIRECTOR)
(336) 253-5371
Entity
Organization
Contact information
Practice address
2442 SANDHURST CT, GASTONIA, NC 28054-2738
(704) 904-9322
Mailing address
1800 CAMDEN RD STE 107-48, CHARLOTTE, NC 28203-4690
(704) 904-9322
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/05/2020
Last updated
02/15/2023
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