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General NPI Number Information
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NPI Number | 1982131132
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN ADULT FAMILY CARE HOME
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 05/18/2017
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Provider Practice Location Address
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Address Line | 3410 NW 8TH ST
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City | LAUDERHILL
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State | FL
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Zip | 33311-6513
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Country | US
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Telephone | 954-865-3382
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 NW 8TH ST
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City | LAUDERHILL
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State | FL
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Zip | 33311-6513
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Country | US
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Telephone | 954-865-3382
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. VILMA MCKAY
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Credential |
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Telephone | 954-534-1066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 6906824
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License Number State | FL
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