Organization
J4 STABILITY & SAFE HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHADAE T WILLIAMS LCSWA LCASA CADC (OWNER/ CEO)
(336) 749-5267
Entity
Organization
Contact information
Practice address
1308 N INDEPENDENCE ST, KINSTON, NC 28501-2908
(336) 749-5267
Mailing address
6201 MAURICE CIR, RURAL HALL, NC 27045-9734
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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