Provider Demographics
NPI:1841988292
Name:SAFEHAVEN INTERNATIONAL, LLC
Entity type:Organization
Organization Name:SAFEHAVEN INTERNATIONAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LA CARLA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:585-752-3127
Mailing Address - Street 1:233 LAGRANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1562
Mailing Address - Country:US
Mailing Address - Phone:585-752-3127
Mailing Address - Fax:877-843-5794
Practice Address - Street 1:233 LAGRANGE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1562
Practice Address - Country:US
Practice Address - Phone:585-752-3127
Practice Address - Fax:877-843-5794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)