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General NPI Number Information
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NPI Number | 1437771870
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR RECOVERY, LLC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 1212 TOD PL NW
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City | WARREN
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State | OH
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Zip | 44485-2475
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Country | US
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Telephone | 330-469-6822
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1212
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City | WARREN
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State | OH
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Zip | 44482-1212
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Country | US
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Telephone | 330-469-6822
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE OFFICER
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Name | LUKE CHARLES METCALF
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Credential |
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Telephone | 330-720-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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