Provider Demographics
NPI:1265273411
Name:SAFE SPACES MENTAL HEALTH
Entity type:Organization
Organization Name:SAFE SPACES MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:EVIE
Authorized Official - Last Name:SCHULLER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, PMHNP-BC
Authorized Official - Phone:515-461-9244
Mailing Address - Street 1:1228 SUNSET DR STE D
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-2401
Mailing Address - Country:US
Mailing Address - Phone:515-461-9244
Mailing Address - Fax:
Practice Address - Street 1:1228 SUNSET DR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-2401
Practice Address - Country:US
Practice Address - Phone:515-205-5113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health