Provider Demographics
NPI:1700404316
Name:SAFIRE1
Entity Type:Organization
Organization Name:SAFIRE1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C/O
Authorized Official - Prefix:MS
Authorized Official - First Name:TAWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-313-3753
Mailing Address - Street 1:101 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-3725
Mailing Address - Country:US
Mailing Address - Phone:551-313-3753
Mailing Address - Fax:
Practice Address - Street 1:101 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3725
Practice Address - Country:US
Practice Address - Phone:551-313-3753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care