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General NPI Number Information
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NPI Number | 1598994790
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 4106 BANCROFT DR
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City | PETERSBURG
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State | VA
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Zip | 23803-8369
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Country | US
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Telephone | 804-919-1931
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Fax |
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Provider Business Mailing Address
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Address Line | 4106 BANCROFT DR
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City | PETERSBURG
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State | VA
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Zip | 23803-8369
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Country | US
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Telephone | 904-919-1931
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MISS LAKEISHA R BRANCH
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Credential |
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Telephone | 804-919-1931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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