Provider Demographics
NPI:1588376834
Name:SAFE SPACE HEALTHCARE SERVICES PLLC
Entity type:Organization
Organization Name:SAFE SPACE HEALTHCARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAAME S
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIRI-BOATENG
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:210-446-4457
Mailing Address - Street 1:4358 LOCKHILL SELMA RD STE 307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4167
Mailing Address - Country:US
Mailing Address - Phone:210-446-4457
Mailing Address - Fax:
Practice Address - Street 1:4358 LOCKHILL SELMA RD STE 307
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4167
Practice Address - Country:US
Practice Address - Phone:210-446-4451
Practice Address - Fax:832-336-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty