| Full Name | Self Haven Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1105 Carla Drive, Cantonment, Florida |
| Authorized Official Name and Position | Melissa D Garner (OWNER) |
| Authorized Official Contact | 8504493883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Haven Llc 1105 Carla Drive Cantonment FL 32533 Ph: (850) 449-3883 | Self Haven Llc 1105 Carla Drive Cantonment FL 32533 Ph: (850) 449-3883 |
| NPI Number | 1013499441 |
|---|---|
| Provider Enumeration Date | 09/01/2018 |
| Last Update Date | 09/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013499441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH11872 (Florida) | Primary |
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› Verified 4 days ago
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