NPIMap

Organization Active NPI

A Safe Haven, L.L.C.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
National Provider Identifier
1124206800
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0274-0016-A Issued in IL
Legal business name
A SAFE HAVEN, L.L.C.
Practice address
2750 W Roosevelt Rd
Chicago, IL 60608
Phone
(773) 435-8429
Fax
(773) 435-8482
NPI assigned
Feb 5, 2008
Last updated
Mar 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brian M Rowland
Title
Ceo
Phone
(312) 372-6707

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0274-0016-A IL Primary
Substance Abuse Rehabilitation Facility 324500000X A-0274-0016-A IL

Addresses

Primary practice location

2750 W Roosevelt Rd
Chicago, IL 60608

Mailing address

15507 Cicero Ave Ste 200
Oak Forest, IL 60452-3633
Phone (312) 372-6707

Other practice location 1

180 W Washington St
Suite 1000
Chicago, IL 60602-2301
Phone (312) 372-6707

Other practice location 2

1930 S Wabash Ave Ste C1
Chicago, IL 60616-4651
Phone (312) 567-9500

Other practice location 3

600 S Wabash Ave
Chicago, IL 60605-1808
Phone (312) 698-4602

Other practice location 4

7355 N Damen Ave
Chicago, IL 60645-2311
Phone (773) 764-6836 ext. 101

Other practice location 5

7346 S Kingston Ave
Chicago, IL 60649-3470
Phone (312) 372-6707 ext. 133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180705001836 IL Part B Supplier - Clinic/Group Practice 9931455946 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
Practice locations: Chicago, IL

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
A Safe Haven LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

180 W Washington St
Ste 1000
Chicago, IL 60602

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1124206800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15507 CICERO AVE STE 200",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523633",
            "telephone_number": "312-372-6707",
            "fax_number": "312-372-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-435-8429",
            "fax_number": "773-435-8482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 W Washington St",
            "address_2": "Suite 1000",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606022301",
            "country_code": "US",
            "telephone_number": "312-372-6707",
            "fax_number": "312-372-6706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1930 S Wabash Ave Ste C1",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606164651",
            "country_code": "US",
            "telephone_number": "312-567-9500",
            "fax_number": "312-281-8621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 S Wabash Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606051808",
            "country_code": "US",
            "telephone_number": "312-698-4602",
            "fax_number": "312-698-4609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7355 N Damen Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606452311",
            "country_code": "US",
            "telephone_number": "773-764-6836 x101",
            "fax_number": "773-905-1344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7346 S Kingston Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606493470",
            "country_code": "US",
            "telephone_number": "312-372-6707 x133",
            "fax_number": "773-375-6861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A SAFE HAVEN, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-372-6707",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0274-0016-A",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0274-0016-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.