SAFE HAVEN CARE SERVICES, LLC (NPI# 1053949602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053949602 |
| Entity Type | Organization |
| Organization Name | SAFE HAVEN CARE SERVICES, LLC |
| Practice Address |
200 Kanawha Ter Ste 1 Saint Albans WV 25177-2808 |
| Mailing Address |
9013 Teays Valley Rd Scott Depot WV 25560-7700 |
| Practice Telephone | 3047551769 |
| Practice Fax Number | 8558439349 |
| Mailing Telephone | 3047551769 |
| Mailing Fax Number | 8558439349 |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |
| Authorized Official Name | MICHAEL ALLEN ROSS (OWNER/CEO) |
| Authorized Official Telephone | 3047551769 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385HR2065X |
Respite Care Specialization: Respite Care, Physical Disabilities, Child |
Respite Care Facility | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 251E00000X | Home Health | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Safe Haven | Other Name - Individual/Organization |
| Street Address |
200 KANAWHA TER STE 1 |
| City | SAINT ALBANS |
| State | WV |
| Zip Code | 25177-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366043655 | Lauren E. Anderson | Technician | 414 Lore Street, St. Albans, WV 25177 | 2020-11-04 |
| 1235730433 | Laura Crist | Technician | 1400 Highland Dr. Apt. #104, St. Albans, WV 25177 | 2020-11-04 |
| 1750982070 | Kathy Carden | Technician | 2734 Knox. Ave., St. Albans, WV 25177 | 2020-11-03 |
| 1245837012 | Donald Troy Blum | Pharmacist | 201 Maccorkle Avenue, St. Albans, WV 25177 | 2020-10-05 |
| 1073022067 | Comprehensive Occupational Med, Physicals, Acad, & Surveillance Sol. | Preventive Medicine | 175 Smiley Drive, St. Albans, WV 25177 | 2017-09-22 |
| 1104291608 | Melinda K. Henline, Ma, Pllc | Psychologist | 200 Kanawha Terrrace, Suite 103, St. Albans, WV 25177 | 2015-12-09 |
| 1285075796 | Brandon Tincher | Physical Therapy Assistant | 2501 Mountain View Drive, St. Albans, WV 25177 | 2013-07-12 |
| 1104129329 | Larry N Pethtel | Pharmacist | 1439 Maccorkle Ave., Saint Albans, WV 25177 | 2010-12-09 |
| 1952580698 | Behavioral Health Solutions LLC | Community/Behavioral Health | 235 Woods Dr, St Albans, WV 25177 | 2007-10-30 |
| 1336284520 | Lagrimas Babiera Sadorra | Family Medicine | 200 Kanawha Terrace, St Albans, WV 25177 | 2007-02-21 |
| Find all providers in zip 25177 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528602950 | True Choice Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 188 Taylor St, Ronceverte, WV 24970-1598 | 2019-10-29 |
| 1356825640 | Focused On You, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1709 Us Route 60 W, Milton, WV 25541-1133 | 2018-09-21 |
| 1891293056 | Linx Community Service, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1307 Williamstown Pike, Williamstown, WV 26187-8168 | 2018-01-23 |
| 1043417975 | Martinsburg Work Center LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24 Integrity Ter, Martinsburg, WV 25401-3524 | 2007-07-03 |
| 1073737706 | Sycamore Run, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Rr 2 Box 215a, Keyser, WV 26726-9230 | 2007-04-12 |
| 1316046956 | Horizons Center for Independent Living Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 934 Williams St, Parkersburg, WV 26101-4851 | 2006-09-21 |
| 1164606935 | Florence Crittenton Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2606 National Rd, Wheeling, WV 26003-5370 | 2007-12-28 |
| 1255548186 | Martin Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 521 Market St, Parkersburg, WV 26101-5150 | 2007-05-17 |
| City | SAINT ALBANS |
| Zip Code | 25177 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.