Provider Demographics
NPI:1669764726
Name:AB SAFE HAVEN PALLIATIVE & HOSPICE CARE, INC.
Entity type:Organization
Organization Name:AB SAFE HAVEN PALLIATIVE & HOSPICE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODNAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-400-5513
Mailing Address - Street 1:2855 TEMPLE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2212
Mailing Address - Country:US
Mailing Address - Phone:562-426-7500
Mailing Address - Fax:562-424-9588
Practice Address - Street 1:2855 TEMPLE AVE STE B
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2212
Practice Address - Country:US
Practice Address - Phone:562-426-7500
Practice Address - Fax:562-424-9588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551721OtherPTAN