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General NPI Number Information
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NPI Number | 1538957972
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Entity Type | Organization
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Legal Business Name | ANN'S SAFE HAVEN LLC
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 218 KINGSWAY ST
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City | FARMINGTON
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State | MO
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Zip | 63640-1026
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Country | US
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Telephone | 573-330-5323
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Fax |
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Provider Business Mailing Address
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Address Line | 218 KINGSWAY ST
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City | FARMINGTON
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State | MO
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Zip | 63640-1026
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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 | OWNER/THERAPIST
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Name | MRS. ALYSSA CRYSTAL FORD
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Credential | MSW, LMSW
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Telephone | 573-330-5323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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