Provider Demographics
NPI:1295356228
Name:FOR SAFETY'S SAKE LLC
Entity Type:Organization
Organization Name:FOR SAFETY'S SAKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUNAKA
Authorized Official - Middle Name:GRAYSON
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:901-237-1554
Mailing Address - Street 1:532 GLADIOLA WAY
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-6848
Mailing Address - Country:US
Mailing Address - Phone:202-696-0634
Mailing Address - Fax:
Practice Address - Street 1:532 GLADIOLA WAY
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6848
Practice Address - Country:US
Practice Address - Phone:202-696-0634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Multi-Specialty