Healthcare Provider Details

I. General information

NPI: 1205407210
Provider Name (Legal Business Name): JEY H'S SAFE HOUSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/09/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 E BASELINE RD
TEMPE AZ
85283-1454
US

IV. Provider business mailing address

1204 E BASELINE RD
TEMPE AZ
85283-1454
US

V. Phone/Fax

Practice location:
  • Phone: 770-800-3006
  • Fax:
Mailing address:
  • Phone: 770-800-3006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. KING HARRISON
Title or Position: VP
Credential:
Phone: 770-800-3006