| Haven Ministries, Inc. @ Agape | |
|
3725b Wrightsville Ave Wilmington NC 28403-4140 | |
| (910) 803-1620 | |
| (215) 902-4882 |
| Full Name | Haven Ministries, Inc. @ Agape |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 3725b Wrightsville Ave, Wilmington, North Carolina |
| Authorized Official Name and Position | Dwight Howard Lysne (DIRECTOR) |
| Authorized Official Contact | 9108031620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven Ministries, Inc. @ Agape 7212 Oyster Ln Wilmington NC 28411-7132 Ph: (910) 803-1620 | Haven Ministries, Inc. @ Agape 3725b Wrightsville Ave Wilmington NC 28403-4140 Ph: (910) 803-1620 |
| NPI Number | 1164735254 |
|---|---|
| Provider Enumeration Date | 07/19/2010 |
| Last Update Date | 07/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164735254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 200301378 (North Carolina) | Primary |
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