Healthcare Provider Details

I. General information

NPI: 1386534121
Provider Name (Legal Business Name): SAFE HAVEN INTEGRATED WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11022 N 28TH DR STE 190
PHOENIX AZ
85029-5633
US

IV. Provider business mailing address

11022 N 28TH DR STE 190
PHOENIX AZ
85029-5633
US

V. Phone/Fax

Practice location:
  • Phone: 678-904-2450
  • Fax:
Mailing address:
  • Phone: 678-904-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY W MURANJA
Title or Position: MEDICAL DIRECTOR
Credential: DNP
Phone: 678-904-2450