Provider Demographics
NPI:1619549755
Name:SAFE HAVEN BEHAVIORAL CENTER LLC
Entity Type:Organization
Organization Name:SAFE HAVEN BEHAVIORAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CBHCM-S
Authorized Official - Prefix:
Authorized Official - First Name:YENI
Authorized Official - Middle Name:
Authorized Official - Last Name:CORCHO AREVALO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CBHCMS
Authorized Official - Phone:305-335-9627
Mailing Address - Street 1:7382 NW 35TH TER UNIT 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1241
Mailing Address - Country:US
Mailing Address - Phone:305-705-5666
Mailing Address - Fax:305-402-6101
Practice Address - Street 1:6187 NW 167TH ST STE H26
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33015-4366
Practice Address - Country:US
Practice Address - Phone:305-705-5666
Practice Address - Fax:305-402-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care