Organization
HAVEN MINISTRIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT HOWARD LYSNE MD, MDIV (DIRECTOR)
(910) 803-1620
Entity
Organization
Contact information
Practice address
3725B WRIGHTSVILLE AVE, WILMINGTON, NC 28403-4140
(910) 803-1620
(215) 902-4882
Mailing address
7212 OYSTER LN, WILMINGTON, NC 28411-7132
(910) 803-1620
(215) 902-4882
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
200301378
NC
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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