Organization
BLUE HAVEN OUTREACH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAKESIA APRIL SAMOAN CHANCE (OWNER)
(910) 785-0519
Entity
Organization
Contact information
Practice address
1832 SAND HILL RD, HOPE MILLS, NC 28348-9587
(910) 785-0519
Mailing address
1832 SAND HILL RD, HOPE MILLS, NC 28348-9587
(910) 785-0519
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
342000000X
Transportation Network Company
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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