Healthcare Provider Details

I. General information

NPI: 1932562857
Provider Name (Legal Business Name): SAFE HAVEN HOME HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15565 NORTHLAND DR W STE 208
SOUTHFIELD MI
48075-5310
US

IV. Provider business mailing address

15565 NORTHLAND DR W STE 208
SOUTHFIELD MI
48075-5310
US

V. Phone/Fax

Practice location:
  • Phone: 248-714-0298
  • Fax:
Mailing address:
  • Phone: 248-714-0298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: LAKESHIA BROWN
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 248-795-4253