Provider Demographics
NPI:1841044690
Name:SAFE HAVEN MENTAL HEALTH LLC
Entity type:Organization
Organization Name:SAFE HAVEN MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBURN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:540-209-9778
Mailing Address - Street 1:440 MONTICELLO AVE
Mailing Address - Street 2:STE 1802 PMB 715264
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:540-209-9778
Mailing Address - Fax:
Practice Address - Street 1:12801 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22551-8041
Practice Address - Country:US
Practice Address - Phone:540-209-9778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)