Provider Demographics
NPI:1124850243
Name:SAFE HEAVEN HOMES LLC
Entity type:Organization
Organization Name:SAFE HEAVEN HOMES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NERVILLE
Authorized Official - Middle Name:NKIPANG
Authorized Official - Last Name:RIH-REH
Authorized Official - Suffix:SR
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:651-529-5117
Mailing Address - Street 1:200 WINTHROP ST S APT 234
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5039
Mailing Address - Country:US
Mailing Address - Phone:651-529-5117
Mailing Address - Fax:
Practice Address - Street 1:216 HAWES AVE
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-6232
Practice Address - Country:US
Practice Address - Phone:651-529-5117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home