Provider Demographics
NPI:1922788231
Name:SAFESPACE MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SAFESPACE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN-CNP
Authorized Official - Prefix:MR
Authorized Official - First Name:EPIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AJEBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-253-2446
Mailing Address - Street 1:2743 NIGHTHAWK CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9678
Mailing Address - Country:US
Mailing Address - Phone:513-253-2446
Mailing Address - Fax:
Practice Address - Street 1:2743 NIGHTHAWK CT
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9678
Practice Address - Country:US
Practice Address - Phone:513-253-2446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty