Provider Demographics
NPI:1619926243
Name:SAFE HARBOR RECOVERY, INC.
Entity Type:Organization
Organization Name:SAFE HARBOR RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CADC I
Authorized Official - Phone:620-532-3440
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:KS
Mailing Address - Zip Code:67068-0286
Mailing Address - Country:US
Mailing Address - Phone:620-532-3440
Mailing Address - Fax:620-532-3477
Practice Address - Street 1:333 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:KS
Practice Address - Zip Code:67068-1335
Practice Address - Country:US
Practice Address - Phone:620-532-3440
Practice Address - Fax:620-532-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS612101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty