Organization
A NEW SAFEHAVEN
Active
Other names
Southwest Washington Safehaven
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA CASSERD-JOHNSON CDP (AMINISTRATOR)
(360) 577-4340
Entity
Organization
Contact information
Practice address
1441 11TH AVE, LONGVIEW, WA 98632-3818
(360) 577-4340
(360) 577-4350
Mailing address
1441 11TH AVE, LONGVIEW, WA 98632-3818
(360) 577-4340
(360) 577-4350
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145054826
DUN #
WA
01
—
602-308-263
UBI NUMBER
WA
01
—
6440SW
REGENCE IDENTIFICATION
WA
Enumeration date
04/23/2007
Last updated
07/21/2022
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