MEDICARE: COZY COVE SAFE HAVEN LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1124769989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COZY COVE SAFE HAVEN LLC

Provider Business Mailing Address
First Line	:	231 LINDA BLVD
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-5138
Country	:	US
Telephone Number	:	662-532-8550
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 LINDA BLVD
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-5138
Country	:	US
Telephone Number	:	662-528-3635
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANITRA FINLEY
Credential	:
Telephone Number	:	662-528-3635

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	09/21/2023

Similar Medicare Providers

1124768502 — SHANITRA FINLEY
Practice Location Address:

231 LINDA BLVD
YAZOO CITY, MS
39194-5138

Practice Phone: 662-532-8550
Practice Fax:

1982562393 — SHIBI MATHEW
Practice Location Address:

8007 SILVERSPOT LN
MISSOURI CITY, TX
77459-5138

Practice Phone: 201-374-1023
Practice Fax:

1326474966 — TAYLOR RILEY JOHNSON
Practice Location Address:

5138 N 2700 W
CEDAR CITY, UT
84721-5597

Practice Phone: 435-327-0529
Practice Fax:

1942787007 — KONI CHRISTENSEN LMT, CHES
Practice Location Address:

5138 W DAY PARK DR
SALT LAKE CITY, UT
84120-2830

Practice Phone: 208-406-8461
Practice Fax:

1629728662 — MR. KEVIN L GOODWIN
Practice Location Address:

5138 LANCE ST APT C
PANAMA CITY, FL
32404-6973

Practice Phone: 850-960-1611
Practice Fax:

1922793090 — ZAINAB ILLO
Practice Location Address:

1006 OAKCREST ST APT 101
IOWA CITY, IA
52246-5138

Practice Phone: 515-227-8225
Practice Fax:

Directions to “COZY COVE SAFE HAVEN LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.