| Safe Space, Slc Llc | |
|
807 E South Temple Ste 200 Salt Lake City UT 84102-1446 | |
| (310) 483-9577 | |
| Not Available |
| Full Name | Safe Space, Slc Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 807 E South Temple Ste 200, Salt Lake City, Utah |
| Authorized Official Name and Position | Jessica Leigh Withee (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3104839577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Safe Space, Slc Llc 807 E South Temple Ste 200 Salt Lake City UT 84102-1446 Ph: (310) 483-9577 | Safe Space, Slc Llc 807 E South Temple Ste 200 Salt Lake City UT 84102-1446 Ph: (310) 483-9577 |
| NPI Number | 1063180057 |
|---|---|
| Provider Enumeration Date | 09/02/2021 |
| Last Update Date | 09/02/2021 |
| Certification Date | 09/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063180057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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