Provider Demographics
NPI:1407000987
Name:SAFE HAVEN OF CHANGE MINISTRIES
Entity Type:Organization
Organization Name:SAFE HAVEN OF CHANGE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-414-7447
Mailing Address - Street 1:18656 FENELON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-2219
Mailing Address - Country:US
Mailing Address - Phone:313-414-7447
Mailing Address - Fax:
Practice Address - Street 1:14847 WILDEMERE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-2158
Practice Address - Country:US
Practice Address - Phone:313-414-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPIRIT LOVE MINISTRIES INTERNATIONAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable