OrganizationA Safe Haven, L.L.C.Clinic/CenterAmbulatory Health Care FacilitiesPractice Address7355 N Damen Ave, Chicago, IL 60645-2311(312) 372-6707PECOS EnrollmentBased on the most recent information from CMS, provider A Safe Haven, L.L.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1235745142Provider TypeOrganizationFull NameA Safe Haven, L.L.C.SubpartNoEnumeration Date9/17/2020Last Updated9/17/2020Contact InformationPractice LocationPractice Address7355 N Damen Ave, Chicago, IL 60645-2311Phone(312) 372-6707FaxUnlisted FaxMailing LocationMailing Address15507 Cicero Ave Ste 200, Oak Forest, IL 60452-3633Phone(312) 372-6707FaxUnlisted FaxAuthorized OfficialNameDzado, Melanie (Insurance Biller)Phone(312) 372-6707Provider TaxonomiesCodeDescriptionLicenseCode261QM0801XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID17002DescriptionOtherIssuerDHS COMMUNITY MENTAL HEALTH CENTER CERTIFICATIONIllinois