Provider Demographics
NPI:1508737156
Name:SAFE SPACE CLINICS, INC
Entity type:Organization
Organization Name:SAFE SPACE CLINICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-593-7233
Mailing Address - Street 1:14431 VENTURA BLVD # 607
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2606
Mailing Address - Country:US
Mailing Address - Phone:855-987-7233
Mailing Address - Fax:
Practice Address - Street 1:17620 BURBANK BLVD APT 2
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1729
Practice Address - Country:US
Practice Address - Phone:855-987-7233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health