Safe Haven House LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-041-810 Issued in NC

Legal business name

SAFE HAVEN HOUSE LLC

Practice address

4250 Old Julian Rd
Box 323
Julian, NC 27283-9217

Phone

(336) 685-4484

Fax

(336) 685-0144

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sandy Staley White

Title

Director

Phone

(336) 685-4484

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1194940957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 OLD JULIAN RD",
            "address_2": "PO BOX 323",
            "city": "JULIAN",
            "state": "NC",
            "postal_code": "272839217",
            "telephone_number": "336-685-4484",
            "fax_number": "336-685-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 OLD JULIAN RD",
            "address_2": "BOX 323",
            "city": "JULIAN",
            "state": "NC",
            "postal_code": "272839217",
            "telephone_number": "336-685-4484",
            "fax_number": "336-685-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "STALEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-685-4484",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-041-810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Joel
• Kamrin Marks
• Meritorious Home Care, Inc.
• Nurtured Counseling and Consulting, PLLC
• Joshua Robbins, PT, DPT
• Betty L Smith, FNP

• All providers in Julian, NC
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.