Organization · NPI-2

A Safe Space LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Atlanta, GA

NPI number1285248773
StatusActive
Last updated in NPPESSep 2, 2020

Details

NPI
1285248773
Entity type
Organization (NPI-2)
Legal business name
A Safe Space LLC
Organization subpart
No
Enumeration date
Sep 2, 2020
Certification date
Sep 2, 2020
Last updated
Sep 2, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

3342 Rose Rdg
Atlanta, GA 30340-4074

Phone 678-558-3930

Mailing address

3342 Rose Rdg
Atlanta, GA 30340-4074

Phone 678-558-3930

Authorized official

Harry Scott Gordon
President
6785583930

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