Provider Demographics
NPI:1578314969
Name:SAFE HAVEN GROUP LLC
Entity Type:Organization
Organization Name:SAFE HAVEN GROUP LLC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRANKUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-587-7572
Mailing Address - Street 1:459 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1061
Mailing Address - Country:US
Mailing Address - Phone:515-587-7572
Mailing Address - Fax:
Practice Address - Street 1:459 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1061
Practice Address - Country:US
Practice Address - Phone:515-587-7572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care