Organization
SAFE HAVEN HOME
Active
Other names
Safe Haven HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LATOYA RENEE CAMERON NP (CEO)
(601) 341-3916
Entity
Organization
Contact information
Practice address
1677 MAIN STREET, FAYETTE, MS 39069
(601) 341-3916
Mailing address
1080 GREAT POINT RD, MCCOMB, MS 39648-4753
(601) 341-3916
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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