Abundance Safe Haven Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL-032-322 Issued in NC

Legal business name

ABUNDANCE SAFE HAVEN INC

Practice address

915 Fiske St
Durham, NC 27703-1615

Phone

(919) 680-2030

NPI assigned

Jan 26, 2007

Last updated

Jun 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Terron Horatious Simpson Sr.

Title

Executive Director

Phone

(919) 680-2030

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1376699819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 HILLANDALE RD",
            "address_2": "1B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 FISKE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277031615",
            "telephone_number": "919-680-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANCE SAFE HAVEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "TERRON",
        "authorized_official_middle_name": "HORATIOUS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-680-2030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-032-322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Durham, NC
• Providers in Durham, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.