SAFE SPACE RESIDENTIAL LLC NPI 1588428635

NPI Information

  • NPI: 1588428635
  • Provider Name: SAFE SPACE RESIDENTIAL LLC
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • Address: 4610 STONEBROOK CT
    GLEN ALLEN, VA
    ZIP 23060
  • Phone: (804) 586-4471

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NPI Details

SAFE SPACE RESIDENTIAL LLC is a community based residential treatment facility mental illness in Glen Allen, VA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. SAFE SPACE RESIDENTIAL LLC NPI is 1588428635. The provider is registered as an organization entity type.

The provider's business location address is:

4610 STONEBROOK CT
GLEN ALLEN, VA
ZIP 23060-632
Phone: (804) 586-4471

The provider's authorized official is Roger Graves .
The authorized official title is Ceo and has the following contact phone number (804) 586-4471.

The enumeration date for this NPI number is 2/9/2024 and was last updated on 2/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2323P00000XPsychiatric Residential Treatment FacilityNo
3320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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