Whalio Doctors

NPI 1588428635

Safe Space Residential LLC

Organisation Mental Illness Community Based Residential Treatment Facility Glen Allen, VA

Practice location

Address
4610 Stonebrook CT, Glen Allen, VA 23060-3632
Phone
(804) 586-4471
Mailing address
4100 Hyde Park Dr, Chester, VA 23831-4826

Authorised official

Name
Roger Graves
Title
Ceo
Phone
(804) 586-4471

Registered specialties (3)

Mental Illness Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320800000X
Mental Health Clinic/Center (Including Community Mental Health Center)
Ambulatory Health Care Facilities Taxonomy 261QM0801X
Psychiatric Residential Treatment Facility
Residential Treatment Facilities Taxonomy 323P00000X

Registry record

NPI
1588428635
Entity type
Organization
NPI issued
9 Feb 2024
Record last updated
9 Feb 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.