Organization
JIMERSON SAFE HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANITA ARLENE TUCKER (EXCUTIVE)
(704) 434-0085
Entity
Organization
Contact information
Practice address
135 SWEETBRIAR CIRCLE, MOOREBORO, NC 28114
(704) 434-0085
(704) 434-0085
Mailing address
135 SWEETBRIAR CIRCLE, POBOX 204, MOORESBORO, NC 28114
(704) 434-0085
(704) 434-0085
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
05/02/2014
Last updated
05/16/2023
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