Provider Demographics
NPI:1073780516
Name:SAFE HAVEN INC
Entity Type:Organization
Organization Name:SAFE HAVEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II
Authorized Official - Phone:541-881-1271
Mailing Address - Street 1:372 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2734
Mailing Address - Country:US
Mailing Address - Phone:541-881-1271
Mailing Address - Fax:541-881-1256
Practice Address - Street 1:372 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2734
Practice Address - Country:US
Practice Address - Phone:541-881-1271
Practice Address - Fax:541-881-1256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health