Provider Demographics
NPI:1760188494
Name:SAFE HAVEN MEDICAL CENTER INC
Entity Type:Organization
Organization Name:SAFE HAVEN MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVELO
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:954-394-2835
Mailing Address - Street 1:6187 NW 167TH ST STE H25
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4352
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 H25
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33015-4352
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:2023-02-03
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty