Blk Haven Corp.
NPI #1184322455 in Lithia Springs, Georgia
Provider Information
- NPI Number
- 1184322455
- Entity Type
- Organization
- Organization Name
- Blk Haven Corp.
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Feb 16, 2023
- Last Updated
- Feb 16, 2023
Practice Location
- Address
- 1633 KARSYN LN
- City
- Lithia Springs
- State
- Georgia
- ZIP Code
- 30122-3970
- Phone
- (619) 330-5601
Authorized Official
- Name
- ASHLEE S WILSON, LPCC
- Title
- CEO
- Phone
- (763) 245-0390
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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