Provider Demographics
NPI:1285444182
Name:SAFE SPACE WELLNESS SERVICES, LLC
Entity type:Organization
Organization Name:SAFE SPACE WELLNESS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAVIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-532-8303
Mailing Address - Street 1:2114 N FLAMINGO RD # 2295
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-3501
Mailing Address - Country:US
Mailing Address - Phone:954-532-8303
Mailing Address - Fax:
Practice Address - Street 1:12028 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3876
Practice Address - Country:US
Practice Address - Phone:954-889-4416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty