Healthcare Provider Details

I. General information

NPI: 1336790781
Provider Name (Legal Business Name): SAFE KEEPINGS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 W MAGDALENA LN
PHOENIX AZ
85041-7815
US

IV. Provider business mailing address

1816 W MAGDALENA LN
PHOENIX AZ
85041-7815
US

V. Phone/Fax

Practice location:
  • Phone: 623-213-5356
  • Fax: 480-383-6782
Mailing address:
  • Phone: 623-213-5356
  • Fax: 480-383-6782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JOHNWICK NATHAN
Title or Position: DIRECTOR
Credential:
Phone: 623-213-5356