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General NPI Number Information
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NPI Number | 1073434916
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN RESPITE CARE LLC
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Dates
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Enumeration Date | 07/24/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 108 PARKS RD
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City | GLEASON
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State | TN
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Zip | 38229-6357
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Country | US
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Telephone | 407-496-9088
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Fax |
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Provider Business Mailing Address
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Address Line | 108 PARKS RD
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City | GLEASON
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State | TN
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Zip | 38229-6357
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Country | US
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Telephone | 407-496-9088
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARQUETTIA BIVENS
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Credential | MBA
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Telephone | 407-496-9088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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