Provider Demographics
NPI:1710343645
Name:SAFEHAVEN COUNSELING SERVICES,LLC
Entity Type:Organization
Organization Name:SAFEHAVEN COUNSELING SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/RN
Authorized Official - Phone:478-278-3328
Mailing Address - Street 1:4004 TURKEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31017-2021
Mailing Address - Country:US
Mailing Address - Phone:478-962-0456
Mailing Address - Fax:
Practice Address - Street 1:2792 US HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-0907
Practice Address - Country:US
Practice Address - Phone:478-278-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty