Safe Haven Enterprises, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SAFE HAVEN ENTERPRISES, LLC

Practice address

222 Grandview Dr SE
Wise, VA 24293-5300

Phone

(276) 393-0622

NPI assigned

Jun 11, 2019

Last updated

Jun 11, 2019By 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

Ms. Jackye Sams

Title

Administrator

Phone

(276) 393-0622

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1831758176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8426 PENDLETON RD",
            "city": "WISE",
            "state": "VA",
            "postal_code": "242937730",
            "telephone_number": "276-393-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 GRANDVIEW DR SE",
            "city": "WISE",
            "state": "VA",
            "postal_code": "242935300",
            "telephone_number": "276-393-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "SAMS",
        "authorized_official_first_name": "JACKYE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "276-393-0622",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rector & Visitors of the University of Virginia (UVA Primary Care Wise)
• Robert D Kilgore, D.M.D., P.C
• Anna Cherie Roberts, CPM
• Hannah Renee Robinson, FNP
• Jazlyn Whitney Rowe, FNP-C
• Katie Scott, M.S. CCC-SLP
• Angela Stallard Short, FNP
• Dawn Short, FNP
• Dana Sibrel, MA, ATC
• St. Mary's Health Wagon

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wise, VA
• Providers in Wise, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.