Organization
CL HAVEN ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY MANESS (OWNER)
(325) 514-8780
Entity
Organization
Contact information
Practice address
4443 LOOP 322, ABILENE, TX 79602-8056
(325) 514-8780
Mailing address
4443 LOOP 322, ABILENE, TX 79602-8056
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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