Provider Demographics
NPI:1578937116
Name:SAFE HAVEN DARTS,LLC
Entity Type:Organization
Organization Name:SAFE HAVEN DARTS,LLC
Other - Org Name:SAFE HAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTON MILLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA
Authorized Official - Phone:740-649-6109
Mailing Address - Street 1:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:OH
Mailing Address - Zip Code:45628-0676
Mailing Address - Country:US
Mailing Address - Phone:740-649-6109
Mailing Address - Fax:
Practice Address - Street 1:38 S PAINT ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3238
Practice Address - Country:US
Practice Address - Phone:740-542-1412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management