NPIMap

Organization Active NPI

Safehaven Family Service, LLC.

  • Foster Care Agency
  • Concord, NC
National Provider Identifier
1629241088
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
SAFEHAVEN FAMILY SERVICE, LLC.
Practice address
109 Corban Ave SW
106
Concord, NC 28025-5129
Phone
(704) 262-2295
Fax
(704) 262-2294
NPI assigned
Apr 8, 2008
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Ms. Veronica Marie Clark
Title
Ceo
Phone
(704) 400-1971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X NU Primary

Addresses

Primary practice location

109 Corban Ave SW
106
Concord, NC 28025-5129

Mailing address

109 Corban Ave SW
106
Concord, NC 28025-5129
Phone (704) 262-2295

National Provider Directory

National Provider Directory
Tax ID family
Safehave Family Service LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

109 Corban Ave SW
Ste 106
Concord, NC 28025
Phone (704) 262-2295

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1629241088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CORBAN AVE SW",
            "address_2": "106",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255129",
            "telephone_number": "704-262-2295",
            "fax_number": "704-262-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CORBAN AVE SW",
            "address_2": "106",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255129",
            "telephone_number": "704-262-2295",
            "fax_number": "704-262-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEHAVEN FAMILY SERVICE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-400-1971",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.