Provider Demographics
NPI:1073707915
Name:SAFE ENTRY, INC
Entity Type:Organization
Organization Name:SAFE ENTRY, INC
Other - Org Name:SAFE ENTRY COMMUNITY HOUSING & SUPPORT SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PERRION
Authorized Official - Middle Name:CARLEW
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-596-7147
Mailing Address - Street 1:483 MYATT DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-3024
Mailing Address - Country:US
Mailing Address - Phone:615-818-0892
Mailing Address - Fax:615-750-2972
Practice Address - Street 1:467 MYATT DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3024
Practice Address - Country:US
Practice Address - Phone:615-860-2244
Practice Address - Fax:615-860-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251B00000X, 320800000X, 320900000X
251S00000X, 261QA0600X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)