Organization
BRIGHT HAVEN RESIDENTIAL & COMMUNITY CARE, INC56
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT CONRAD EVANS (PRESIDENT)
(910) 630-3758
Entity
Organization
Contact information
Practice address
3608 THORNDIKE DR, FAYETTEVILLE, NC 28311-0309
(910) 630-3758
Mailing address
PO BOX 9338, FAYETTEVILLE, NC 28311-9084
(910) 630-3758
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
NC
Other
Enumeration date
01/03/2007
Last updated
09/11/2025
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