Provider Demographics
NPI:1629770573
Name:SAFE HAVEN ABA
Entity Type:Organization
Organization Name:SAFE HAVEN ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEMESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-438-3089
Mailing Address - Street 1:#1069 2933 VAUXHALL ROAD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088
Mailing Address - Country:US
Mailing Address - Phone:862-438-3089
Mailing Address - Fax:
Practice Address - Street 1:39 BOYDEN PKWY
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2410
Practice Address - Country:US
Practice Address - Phone:862-438-3089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health