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Organization
MARYS SAFE HAVEN LLC
Active
Organization
MARYS SAFE HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA MCQUEEN (CEO)
(470) 432-6992
Entity
Organization
Contact information
Practice address
755 MOUNTAIN RIDGE WAY, LITHONIA, GA 30058-2923
(470) 432-6992
Mailing address
755 MOUNTAIN RIDGE WAY, LITHONIA, GA 30058-2923
(470) 432-6992
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
Primary
—
—
172A00000X
Driver
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
11/15/2025
Last updated
11/15/2025
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