A Safe Haven Residential Support Services LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

A SAFE HAVEN RESIDENTIAL SUPPORT SERVICES LLC

Doing business as

A Safe Haven Residential Support Services, LLC

Practice address

2117 Smith Ave Ste C
Chesapeake, VA 23320-2519

Phone

(757) 580-1525

Fax

(757) 257-0351

NPI assigned

Jul 20, 2023

Last updated

Jul 20, 2023By 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

Mrs. Kimala BradyNPI 1194260315

Title

Ceo

Phone

(757) 748-8570

Specialties & licenses 1

Addresses

Other names 1

• A Safe Haven Residential Support Services, LLC Doing business as

Locations

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.

• Kimala Brady

  • Home Health Agency
  • Chesapeake, VA
  • NPI 1194260315
  NPD Authorized official

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1649950007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 SMITH AVE STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202519",
            "telephone_number": "757-580-1525",
            "fax_number": "757-257-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 SMITH AVE STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202519",
            "telephone_number": "757-580-1525",
            "fax_number": "757-257-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SAFE HAVEN RESIDENTIAL SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "KIMALA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-748-8570",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Safe Haven Residential Support Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Developmentally Disabled Services Day Training Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.