Organization
HAVEN MENTAL HEALTH & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RUSSELL SALYER III (REGISTERED AGENT)
(307) 871-2728
Entity
Organization
Contact information
Practice address
3237 EMANUEL CHURCH RD, LEXINGTON, SC 29073-8940
(803) 694-7040
(803) 694-7038
Mailing address
1792 S LAKE DR STE 90-235, LEXINGTON, SC 29073-6824
(803) 694-7040
(803) 694-7038
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/27/2024
Last updated
03/28/2025
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