National Provider Identifier Database

SAFE HARBOUR LIVING LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.


Contact Information

SAFE HARBOUR LIVING, LLC
3784 FREMONT DR
ELLENWOOD, GA30294-6660
Phone: 770-474-4472
Fax: 770-972-1791
Website:
Specialty Taxonomy Code
* Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X
Residential Treatment Facility, Physical Disabilities 320700000X

* Indicates primary specialty

NPI Profile & details for SAFE HARBOUR LIVING, LLC

NPI Number 1316246986
Legal business name
LBN
SAFE HARBOUR LIVING, LLC
Authorized official TALIS BURRELL - (CEO)
Entity Organization
Organization subpart No
Enumeration date 03/22/2011
Last updated 03/22/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 031013099

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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