Provider Demographics
NPI:1356232573
Name:SAFEHAVEN CARE FAMILY AND GROUPHOME FACILITIES LLC
Entity type:Organization
Organization Name:SAFEHAVEN CARE FAMILY AND GROUPHOME FACILITIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATRESHANAE
Authorized Official - Middle Name:LAMON
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-301-4313
Mailing Address - Street 1:1520 SEABISCUIT DR
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28371-7714
Mailing Address - Country:US
Mailing Address - Phone:910-301-4313
Mailing Address - Fax:
Practice Address - Street 1:708 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-4977
Practice Address - Country:US
Practice Address - Phone:910-280-8783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-14
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness