Healthcare Provider Details

I. General information

NPI: 1023215183
Provider Name (Legal Business Name): SAFE HARBOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2982 PETUNIA LN
LAS CRUCES NM
88007-5090
US

IV. Provider business mailing address

2982 PETUNIA LN
LAS CRUCES NM
88007-5090
US

V. Phone/Fax

Practice location:
  • Phone: 505-312-9352
  • Fax:
Mailing address:
  • Phone: 505-312-9352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTINE OLIVIA CHAPMAN
Title or Position: DIRECTOR
Credential:
Phone: 505-312-9352