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 today at 4:18 PM.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