Safe Haven Assisted Living Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SAFE HAVEN ASSISTED LIVING HOME LLC

Practice address

19949 W Harrison St
Buckeye, AZ 85326-5115

Phone

(623) 377-7208

NPI assigned

Mar 14, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Jatan Clark, MBA

Title

Owner

Phone

(708) 269-3891

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1992406151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 N DYSART RD STE 106",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19949 W HARRISON ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853265115",
            "telephone_number": "623-377-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN ASSISTED LIVING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JATAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-269-3891",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey A Sager, ND
• Malikah Saleem
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• Omaima Sami Samain, DDS

• Assisted Living Facility in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.