Provider Demographics
NPI:1093559114
Name:SAFE SPACE CONNECT, PLLC
Entity type:Organization
Organization Name:SAFE SPACE CONNECT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BENIAM
Authorized Official - Middle Name:ASTER MEGABI AWOKE
Authorized Official - Last Name:BETSIHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-900-0023
Mailing Address - Street 1:2346 BELT LINE RD # 451011
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7106
Mailing Address - Country:US
Mailing Address - Phone:903-900-0023
Mailing Address - Fax:
Practice Address - Street 1:2213 WINDY DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7553
Practice Address - Country:US
Practice Address - Phone:903-900-0023
Practice Address - Fax:866-477-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty