Provider Demographics
NPI:1063441848
Name:SAFE HORIZON INC
Entity type:Organization
Organization Name:SAFE HORIZON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP MENTAL HEALTH PROGRAMS
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-328-8110
Mailing Address - Street 1:50 COURT ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4879
Mailing Address - Country:US
Mailing Address - Phone:347-328-8110
Mailing Address - Fax:347-328-8117
Practice Address - Street 1:50 COURT ST
Practice Address - Street 2:SUITE 901
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4879
Practice Address - Country:US
Practice Address - Phone:347-328-8110
Practice Address - Fax:347-328-8117
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAFE HORIZON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-02
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7914100B1041C0700X
NY7914100C1041C0700X
NY7914100E1041C0700X
NY7914100D1041C0700X
NY7914100A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01090019Medicaid
NYA100117157Medicare UPIN
NY01090019Medicaid