Provider Demographics
NPI:1942746961
Name:BEHAVEN WELLNESS RESOURCES, INC.
Entity Type:Organization
Organization Name:BEHAVEN WELLNESS RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WHAM, CPS, PP
Authorized Official - Prefix:
Authorized Official - First Name:OLUMAYOWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OJEMUYIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-576-5604
Mailing Address - Street 1:1532 HAVEN CREST DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-4966
Mailing Address - Country:US
Mailing Address - Phone:770-576-5604
Mailing Address - Fax:
Practice Address - Street 1:1532 HAVEN CREST DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-4966
Practice Address - Country:US
Practice Address - Phone:770-576-5604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health