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General NPI Number Information
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NPI Number | 1912719022
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR OF ERIN
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 32 S SPRING ST
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City | ERIN
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State | TN
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Zip | 37061
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Country | US
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Telephone | 901-570-0120
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 505
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City | ATOKA
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State | TN
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Zip | 38004-0505
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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 | EXECUTIVE DIRECTOR
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Name | BRAD BOWIE
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Credential |
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Telephone | 901-331-1814
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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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