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Organization

HAVEN OF POSITIVE ENRICHMENT, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES EDWARD GUILFORD Q.M.H.P. (EXECUTIVE DIRECTOR/CEO)
(252) 946-9427
Entity
Organization

Contact information

Practice address
858 HACKNEY AVE, WASHINGTON, NC 27889-4246
(252) 946-9427
(252) 946-9872
Mailing address
858 HACKNEY AVE, WASHINGTON, NC 27889-4246
(252) 946-9427
(252) 946-9872

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017R5
BLUECROSSBLUESHIELD OF NC
NC
05
8301067B
NC
05
8301067G
NC
05
8301067H
NC
Enumeration date
10/04/2006
Last updated
07/14/2007
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