Organization Name: | SAFE HAVEN ADULT DAY AND MEDICAL SERVICES, LLC |
NPI Number: | 1962448308 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH ARNETTA RICH (OWNER) |
Mailing Address: | 12307 Charles Lacey Dr Manassas |
State: | VA US |
Postal Code: | 201128837 |
Phone Number: | 7037913288 |
Fax Number: | 7037949987 |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 08/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0101052792 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |