MEDICARE: SAVE HAVEN

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	324500000X	Substance Abuse Rehabilitation Facility		FL

General Provider Information

NPI Number	:	1326459959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVE HAVEN

Provider Business Mailing Address
First Line	:	PO BOX 7952
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33482-7952
Country	:	US
Telephone Number	:	561-777-0241
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 SW 12TH AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-1534
Country	:	US
Telephone Number	:	561-777-0241
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	GREGORY DURAND GOYINS
Credential	:	MBR
Telephone Number	:	561-777-0241

Provider Enumeration Date	:	05/16/2014
Last Update Date	:	05/16/2014

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Directions to “SAVE HAVEN ” Practice Location

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