Provider Demographics
NPI:1245516236
Name:SAFE HAVEN HOSPICE LLC
Entity type:Organization
Organization Name:SAFE HAVEN HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:318-458-5231
Mailing Address - Street 1:6007 FINANCIAL PLZ
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2655
Mailing Address - Country:US
Mailing Address - Phone:318-286-1852
Mailing Address - Fax:
Practice Address - Street 1:6007 FINANCIAL PLZ
Practice Address - Street 2:SUITE 114
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2655
Practice Address - Country:US
Practice Address - Phone:318-286-1852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based