Organization
SAFE HAVEN INTEGRATED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KATIA TRIONNE GAMMAGE (OWNER)
(317) 759-4738
Entity
Organization
Contact information
Practice address
1115 CLOVER ST, SOUTH BEND, IN 46615-1205
(317) 759-4738
Mailing address
PO BOX 241074, SPEEDWAY, IN 46224-9274
(317) 759-4738
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TR0400X
Rehabilitation Psychologist
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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