| Haven Mental Health & Wellness | |
|
3237 Emanuel Church Rd Lexington SC 29073-8940 | |
| (803) 694-7040 | |
| (803) 694-7038 |
| Full Name | Haven Mental Health & Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 3237 Emanuel Church Rd, Lexington, South Carolina |
| Authorized Official Name and Position | James Russell Salyer (REGISTERED AGENT) |
| Authorized Official Contact | 3078712728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven Mental Health & Wellness 1792 S Lake Dr Ste 90-235 Lexington SC 29073-6824 Ph: (803) 694-7040 | Haven Mental Health & Wellness 3237 Emanuel Church Rd Lexington SC 29073-8940 Ph: (803) 694-7040 |
| NPI Number | 1942056122 |
|---|---|
| Provider Enumeration Date | 04/27/2024 |
| Last Update Date | 06/18/2024 |
| Certification Date | 06/18/2024 |
| Medicare PECOS PAC ID | 3779023890 |
|---|---|
| Medicare Enrollment ID | O20240904001969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942056122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kimberly Kay Salyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811761893 PECOS PAC ID: 4385093970 Enrollment ID: I20231207002771 |
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