SAFE HAVEN LLC NPI 1164925772

NPI Information

  • NPI: 1164925772
  • Provider Name: SAFE HAVEN LLC
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Doing Business As: GENESIS HEALTH & WELLNESS CENTER
  • Address: 2029 WASHINGTON AVE
    EVANSVILLE, IN
    ZIP 47714
  • Phone: (812) 602-4022

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NPI Details

SAFE HAVEN LLC is a community behavioral health in Evansville, IN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SAFE HAVEN LLC NPI is 1164925772. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Genesis Health & Wellness Center.

The provider's business location address is:

2029 WASHINGTON AVE
EVANSVILLE, IN
ZIP 47714-257
Phone: (812) 602-4022
Fax: (812) 602-4023

The provider's authorized official is Michael G Hagedorn .
The authorized official title is Managing Member and has the following contact phone number (812) 499-7950.

The enumeration date for this NPI number is 3/10/2018 and was last updated on 6/29/2022.

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 Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorNo
2101YA0400XCounselorAddiction (Substance Use Disorder)No
3101YM0800XCounselorMental HealthNo
41041C0700XSocial WorkerClinicalNo
5261Q00000XClinic/CenterNo
6364S00000XClinical Nurse SpecialistNo
7364SF0001XClinical Nurse SpecialistFamily HealthNo
8251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300058088MEDICAIDINDIANA
2300063279MEDICAIDINDIANA

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: 11/21/2025

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