Provider Demographics
NPI:1346792439
Name:SAFE HEAVEN CARE, INC.
Entity Type:Organization
Organization Name:SAFE HEAVEN CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEKRY
Authorized Official - Middle Name:RESHAD
Authorized Official - Last Name:SEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-693-5482
Mailing Address - Street 1:2201 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE B 107
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3327
Mailing Address - Country:US
Mailing Address - Phone:615-693-5482
Mailing Address - Fax:
Practice Address - Street 1:2201 MURFREESBORO PIKE
Practice Address - Street 2:SUITE B 107
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3327
Practice Address - Country:US
Practice Address - Phone:615-693-5482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000013622251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ018341Medicaid