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General NPI Number Information
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NPI Number | 1215084876
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR HOSPICE, LLC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 10/12/2025
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Provider Practice Location Address
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Address Line | 733 W MAIN ST STE C
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City | FREDERICKTOWN
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State | MO
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Zip | 63645-1143
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Country | US
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Telephone | 573-783-7625
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Fax | 573-783-2126
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Provider Business Mailing Address
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Address Line | PO BOX 2130
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City | DAPHNE
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State | AL
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Zip | 36526-2130
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Country | US
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Telephone | 205-652-6167
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Fax | 205-742-0028
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Authorized Official
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Title or Position | CEO
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Name | MR. LEWIS C. BLAIR
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Credential |
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Telephone | 52-742-0028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1076HO
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License Number State | MO
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