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General NPI Number Information
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NPI Number | 1619549755
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN BEHAVIORAL CENTER LLC
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 6187 NW 167TH ST STE H26
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City | MIAMI GARDENS
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State | FL
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Zip | 33015-4366
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Country | US
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Telephone | 305-705-5666
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Fax | 305-402-6101
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Provider Business Mailing Address
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Address Line | 7382 NW 35TH TER UNIT 106
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City | MIAMI
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State | FL
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Zip | 33122-1241
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Country | US
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Telephone | 305-705-5666
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Fax | 305-402-6101
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | LUIS LEDESMA
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Credential |
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Telephone | 305-335-9627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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