Organization Active NPI

Safe Haven Adult Day and Medical Services, LLC

  • General Practice Physician
  • Manassas, VA
National Provider Identifier
1962448308
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101052792 Issued in VA
Legal business name
SAFE HAVEN ADULT DAY AND MEDICAL SERVICES, LLC
Practice address
12307 Charles Lacey Dr
Manassas, VA 20112-8837
Phone
(703) 791-3288
Fax
(703) 794-9987
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Dr. Deborah Arnetta Rich, M.D.
Title
Owner
Phone
(703) 791-3288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 0101052792 VA Primary

Addresses

Primary practice location

12307 Charles Lacey Dr
Manassas, VA 20112-8837

Mailing address

12307 Charles Lacey Dr
Manassas, VA 20112-8837
Phone (703) 791-3288

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1962448308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12307 CHARLES LACEY DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201128837",
            "telephone_number": "703-791-3288",
            "fax_number": "703-794-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12307 CHARLES LACEY DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201128837",
            "telephone_number": "703-791-3288",
            "fax_number": "703-794-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN ADULT DAY AND MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "ARNETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-791-3288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101052792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.