NPIMap

Organization Active NPI

Safe Haven Care, Inc.

  • In Home Supportive Care Agency
  • Bend, OR
National Provider Identifier
1992253512
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
15-2210 Issued in OR
Legal business name
SAFE HAVEN CARE, INC.
Doing business as
Safe Haven Care
Practice address
1005 NW Galveston Ave Ste 200
Bend, OR 97703-2481
Phone
(541) 678-5838
Fax
(888) 937-7476
NPI assigned
Sep 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Authorized official

Name
Mr. Michael Dean Bautista
Title
Owner/President
Phone
(541) 678-5838

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 15-2210 OR Primary
In Home Supportive Care Agency 253Z00000X 15-2180 OR

Addresses

Primary practice location

1005 NW Galveston Ave Ste 200
Bend, OR 97703-2481

Mailing address

PO Box 1416
Bend, OR 97709-1416
Phone (541) 678-5838

Other identifiers 2

IdentifierTypeStateIssuer
500656177MedicaidOR
500656166MedicaidOR

Other names 1

  • Safe Haven Care Doing business as

National Provider Directory

National Provider Directory

Locations

1005 NW Galveston Ave
Ste 200
Bend, OR 97703
Phone (541) 678-5838

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1992253512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1416",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977091416",
            "telephone_number": "541-678-5838",
            "fax_number": "888-937-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 NW GALVESTON AVE STE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032481",
            "telephone_number": "541-678-5838",
            "fax_number": "888-937-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "541-678-5838",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "15-2210",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "15-2180",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500656177",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500656166",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safe Haven Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.