# SAFE HAVEN HOUSE LLC

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

## Provider details

- **NPI number:** 1194940957
- **Authorized official:** MRS. SANDY STALEY WHITE (DIRECTOR)
- **Authorized official phone:** (336) 685-4484

## Contact information

- **Practice address:** 4250 OLD JULIAN RD, BOX 323, JULIAN, NC 27283-9217
- **Practice address phone:** (336) 685-4484
- **Practice address fax:** (336) 685-0144
- **Mailing address:** 4250 OLD JULIAN RD, PO BOX 323, JULIAN, NC 27283-9217
- **Mailing address phone:** (336) 685-4484
- **Mailing address fax:** (336) 685-0144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-041-810 | NC | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 05/14/2008