Organization
PRECIOUS HAVEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA M. MCALLISTER (DIRECTOR/OWNER)
(910) 868-6092
Entity
Organization
Contact information
Practice address
7762 HAZELWOOD AVE, FAYETTEVILLE, NC 28314-6246
(910) 868-6092
(910) 868-8882
Mailing address
PO BOX 25821, FAYETTEVILLE, NC 28314-5013
(910) 868-6092
(910) 868-8882
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-026-673
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301769
—
NC
Enumeration date
12/16/2009
Last updated
12/16/2009
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