NICKELI'S SAFE HAVEN INC NPI 1891266557

NPI Information

NPI: 1891266557
Provider Name: NICKELI'S SAFE HAVEN INC
Classification: Voluntary or Charitable - 251V00000X
Entity Type: Organization

CLIA Number: 14D2236460

Address:
9057 S PARNELL AVE
CHICAGO, IL
ZIP 60620
Phone: (773) 960-3024
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NICKELI'S SAFE HAVEN INC is a voluntary or charitable in Chicago, IL. NICKELI'S SAFE HAVEN INC NPI is 1891266557. The provider is registered as an organization entity type.

The provider's business location address is:

9057 S PARNELL AVE
CHICAGO, IL
ZIP 60620-240
Phone: (773) 960-3024

The provider's authorized official is Brandyn Garner .
The authorized official title is President and has the following contact phone number (773) 960-3024.

The CLIA number assigned to this NPI record is 14D2236460 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/6/2018 and was last updated on 9/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	291U00000X	Clinical Medical Laboratory	No
2	251S00000X	Community/Behavioral Health	No
3	251V00000X	Voluntary or Charitable	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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