Organization
HAVENS RECOVERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARD OPPONG DO (CEO)
(614) 440-2775
Entity
Organization
Contact information
Practice address
4461 BROADWAY, GROVE CITY, OH 43123-3064
(614) 594-2141
Mailing address
4461 BROADWAY, GROVE CITY, OH 43123-3064
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/13/2017
Last updated
08/22/2017
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