Healthcare Provider Details

I. General information

NPI: 1497048284
Provider Name (Legal Business Name): SAAFE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MADISON AVE
DAYTONA BEACH FL
32114-1811
US

IV. Provider business mailing address

901 MADISON AVE
DAYTONA BEACH FL
32114-1811
US

V. Phone/Fax

Practice location:
  • Phone: 386-334-4583
  • Fax:
Mailing address:
  • Phone: 386-334-4583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberADC-010572-2015
License Number StateFL

VIII. Authorized Official

Name: DR. VANESSA HARVEY-LENTS
Title or Position: CEO
Credential: RMFT
Phone: 386-308-5889