Provider Demographics
NPI:1144039041
Name:SAFE HAVEN HOME MODIFICATIONS CONSULTING PLLC
Entity type:Organization
Organization Name:SAFE HAVEN HOME MODIFICATIONS CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:207-752-3234
Mailing Address - Street 1:21 LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-2134
Mailing Address - Country:US
Mailing Address - Phone:207-752-3234
Mailing Address - Fax:
Practice Address - Street 1:21 LOCUST LN
Practice Address - Street 2:
Practice Address - City:SOUTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03908-2134
Practice Address - Country:US
Practice Address - Phone:207-752-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty