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General NPI Number Information
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NPI Number | 1104624279
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN COUNSELING CENTER
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 3715 E OVERLAND RD STE 100
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City | MERIDIAN
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State | ID
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Zip | 83642-8305
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Country | US
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Telephone | 208-866-7059
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Fax |
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Provider Business Mailing Address
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Address Line | 11407 W REUTZEL DR
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City | BOISE
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State | ID
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Zip | 83709-4404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | COURTNEY BURCH
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Credential |
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Telephone | 208-890-2177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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