| Haven Developmental Care | |
|
4794 Michael Jay St Snellville GA 30039-7630 | |
| (770) 761-3402 | |
| (770) 679-4561 |
| Full Name | Haven Developmental Care |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4794 Michael Jay St, Snellville, Georgia |
| Authorized Official Name and Position | Carol Agatha Trim-bagot (DIRECTOR/CEO) |
| Authorized Official Contact | 7707613402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven Developmental Care 4794 Michael Jay St Snellville GA 30039-7630 Ph: (770) 761-3402 | Haven Developmental Care 4794 Michael Jay St Snellville GA 30039-7630 Ph: (770) 761-3402 |
| NPI Number | 1902189723 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 09/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902189723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CLA000738 (Georgia) | Primary |
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