| Safe Space Residential Llc | |
|
4610 Stonebrook Ct Glen Allen VA 23060-3632 | |
| (804) 586-4471 | |
| Not Available |
| Full Name | Safe Space Residential Llc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 4610 Stonebrook Ct, Glen Allen, Virginia |
| Authorized Official Name and Position | Roger Graves (CEO) |
| Authorized Official Contact | 8045864471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Safe Space Residential Llc 4100 Hyde Park Dr Chester VA 23831-4826 Ph: (804) 586-4471 | Safe Space Residential Llc 4610 Stonebrook Ct Glen Allen VA 23060-3632 Ph: (804) 586-4471 |
| NPI Number | 1588428635 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588428635 | NPI | - | NPPES |
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