MEDICARE: A SAFE HAVEN MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1043147242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A SAFE HAVEN MANAGEMENT

Provider Business Mailing Address
First Line	:	8 N BROAD ST E STE 201
Second Line	:
City	:	ANGIER
State	:	NC
Zip	:	27501-5638
Country	:	US
Telephone Number	:	919-400-7863
Fax Number	:	919-460-1895

Provider Business Practice Location Address
First Line	:	8 N BROAD ST E STE 201
Second Line	:
City	:	ANGIER
State	:	NC
Zip	:	27501-5638
Country	:	US
Telephone Number	:	919-400-7863
Fax Number	:	919-460-1895

Authorized Official
Title or Position	:	OWNER
Name	:	TREVOR A ULRICH
Credential	:	CBLC, MA
Telephone Number	:	919-400-7864

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “A SAFE HAVEN MANAGEMENT ” Practice Location

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