# HARVEST SAFE HAVEN FOR BOYS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174132807
- **Authorized official:** MR. DANIEL PARK (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (951) 295-8239

## Contact information

- **Practice address:** 5425 SIERRA VISTA AVE, RIVERSIDE, CA 92505-3113
- **Practice address phone:** (951) 715-3126
- **Practice address fax:** (951) 531-8605
- **Mailing address:** 3380 LA SIERRA AVE STE 104-242, RIVERSIDE, CA 92503-5271
- **Mailing address phone:** (951) 715-3126
- **Mailing address fax:** (951) 531-8605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2020
- **Last updated:** 07/28/2020