Organization
HEALTH HAVEN LLC
Active
Other names
HEALTH HAVEN LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD ASIM NISAR (MEDICAL DIRECTOR)
(516) 640-6937
Entity
Organization
Contact information
Practice address
308 NW 5TH AVE, OKEECHOBEE, FL 34972-2568
(863) 261-8354
(786) 221-4107
Mailing address
308 NW 5TH AVE, OKEECHOBEE, FL 34972-2568
(863) 261-8354
(863) 638-5637
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
ME111621
FL
Other
Enumeration date
02/19/2015
Last updated
09/09/2024
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