Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Club Haven Family Practice

Organization Specialist · NPI 1902869829

Club Haven Family Practice is a Specialist in Winston Salem, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006

Practice location Address checks out

2801 Lyndhurst Ave
Winston Salem, NC 27103-4109
Phone: (336) 768-9575
Fax: (336) 774-1737
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 40378/30659 (NC)

Record details

NPI number1902869829
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Jolly — Owner · (336) 768-9575
NPI enumeratedApril 11, 2006
Last updated in NPPESAugust 22, 2020
Mailing address2801 Lyndhurst Ave, Winston-Salem, NC 27103-4109

Other providers in Winston Salem