MEDICARE: SAFI HOME 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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1427791250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFI HOME LLC

Provider Business Mailing Address
First Line	:	6325 W RAYMOND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-0135
Country	:	US
Telephone Number	:	480-417-2587
Fax Number	:

Provider Business Practice Location Address
First Line	:	6325 W RAYMOND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-0135
Country	:	US
Telephone Number	:	480-417-2587
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LEON NTWARABAKIGA
Credential	:
Telephone Number	:	480-417-2587

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	11/05/2022

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Directions to “SAFI HOME LLC ” Practice Location

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