| NPI | 1942936620 |
|---|---|
| Doing Business As | BLK HAVEN |
| Entity Type | Organization |
| Authorized Contact | ASHLEE S WILSON CEO/ Co Founder 763-245-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |