Provider Demographics
NPI:1275271850
Name:JUBILEE'S SAFE HAVEN
Entity Type:Organization
Organization Name:JUBILEE'S SAFE HAVEN
Other - Org Name:JUBILEE'S SAFE HAVEN INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL ASSISTANT
Authorized Official - Phone:202-987-8143
Mailing Address - Street 1:1717 N ST NW STE 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2827
Mailing Address - Country:US
Mailing Address - Phone:202-987-8143
Mailing Address - Fax:
Practice Address - Street 1:1717 N ST NW STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2827
Practice Address - Country:US
Practice Address - Phone:202-987-8143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness