| Organization Name: | SAFE HARBOUR LIVING, LLC |
| NPI Number: | 1316246986 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TALIS BURRELL (CEO) |
| Mailing Address: | 3784 Fremont Dr Ellenwood |
| State: | GA US |
| Postal Code: | 302946660 |
| Phone Number: | 7704744472 |
| Fax Number: | 7709721791 |
| NPI Enumeration Date: | 03/22/2011 |
| NPI Last Update Date: | 03/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320700000X |
| License Number: | 031013099 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |