Provider Demographics
NPI:1700619533
Name:SAFESPACE LLC
Entity type:Organization
Organization Name:SAFESPACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YARED
Authorized Official - Middle Name:
Authorized Official - Last Name:DARCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-510-3230
Mailing Address - Street 1:12655 SW CENTER ST STE 145
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12655 SW CENTER ST STE 145
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1864
Practice Address - Country:US
Practice Address - Phone:619-510-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty