Provider Demographics
NPI:1942643432
Name:SAFE HAVEN HEALTH CARE INC
Entity Type:Organization
Organization Name:SAFE HAVEN HEALTH CARE INC
Other - Org Name:SAFE HAVEN HOSPITAL OF TREASURE VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BURPEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-221-4721
Mailing Address - Street 1:620 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:ID
Mailing Address - Zip Code:83313-5174
Mailing Address - Country:US
Mailing Address - Phone:208-788-7180
Mailing Address - Fax:888-222-6504
Practice Address - Street 1:8050 W NORTHVIEW ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7126
Practice Address - Country:US
Practice Address - Phone:208-327-0504
Practice Address - Fax:208-327-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID55283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1942643432Medicaid
ID1942643432OtherMEDICAIS