| Bright Haven Residential & Community Care, Inc56 | |
|
3608 Thorndike Dr Fayetteville NC 28311-0309 | |
| (910) 630-3758 | |
| Not Available |
| Full Name | Bright Haven Residential & Community Care, Inc56 |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 3608 Thorndike Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Vincent Conrad Evans (PRESIDENT) |
| Authorized Official Contact | 9106303758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Haven Residential & Community Care, Inc56 Po Box 9338 Fayetteville NC 28311-9084 Ph: (910) 630-3758 | Bright Haven Residential & Community Care, Inc56 3608 Thorndike Dr Fayetteville NC 28311-0309 Ph: (910) 630-3758 |
| NPI Number | 1336206887 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336206887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (North Carolina) | Primary |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | (North Carolina) | Primary |
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