Safe Haven Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SAFE HAVEN SERVICES, LLC

Practice address

15508 W Bell Rd Ste 101 #280
Surprise, AZ 85374-2432

Phone

(602) 695-0876

Fax

(602) 391-2210

NPI assigned

Aug 4, 2020

Organization subpart

No

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

Authorized official

Name

Rebecca Renee Nichols

Title

Director

Phone

(602) 695-0876

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1619587789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15508 W BELL RD STE 101 #280",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742432",
            "telephone_number": "602-695-0876",
            "fax_number": "602-391-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15508 W BELL RD STE 101 #280",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742432",
            "telephone_number": "602-695-0876",
            "fax_number": "602-391-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-10-06",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-695-0876"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rnichols@safehavenservicesaz.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15243 W Honeysuckle Ln",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853743493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.