| Youth Safe Haven | |
|
3602 26th Ave Sacramento CA 95820-4804 | |
| (916) 596-5928 | |
| (866) 310-8868 |
| Full Name | Youth Safe Haven |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3602 26th Ave, Sacramento, California |
| Authorized Official Name and Position | Theo Nkwopara (PRESIDENT/CEO) |
| Authorized Official Contact | 9164752557 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Safe Haven Po Box 293744 Sacramento CA 95829-3744 Ph: (916) 596-5928 | Youth Safe Haven 3602 26th Ave Sacramento CA 95820-4804 Ph: (916) 596-5928 |
| NPI Number | 1225041668 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 11/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225041668 | NPI | - | NPPES |
| 1127620 | Other | CA | CALIFORNIA DGS-SMALL BUSINESS AND DVBE SERVICES |
| C2329546 | Other | CA | CALIFORNIA SECRETARY OF STATE |
| 1000162 | Other | CA | SACRAMENTO COUNTY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1000162 (California) | Primary |
| 251V00000X | Voluntary Or Charitable | 1000162 (California) | Secondary |
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