Provider Demographics
NPI:1023553120
Name:MIAYEN INC.
Entity Type:Organization
Organization Name:MIAYEN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOAZEAH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA, QMHP,
Authorized Official - Phone:980-333-5551
Mailing Address - Street 1:113 S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5427
Mailing Address - Country:US
Mailing Address - Phone:980-333-5551
Mailing Address - Fax:
Practice Address - Street 1:113 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5427
Practice Address - Country:US
Practice Address - Phone:980-333-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC20140602-3979251B00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management