Organization
A SAFE HAVEN, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE DZADO (INSURANCE BILLER)
(312) 372-6707
Entity
Organization
Contact information
Practice address
7355 N DAMEN AVE, CHICAGO, IL 60645-2311
(312) 372-6707
Mailing address
15507 CICERO AVE STE 200, OAK FOREST, IL 60452-3633
(312) 372-6707
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17002
DHS COMMUNITY MENTAL HEALTH CENTER CERTIFICATION
IL
Enumeration date
09/17/2020
Last updated
09/17/2020
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