Provider Demographics
NPI:1952170532
Name:SAFE SPACE FOR FAMILY HEALING
Entity Type:Organization
Organization Name:SAFE SPACE FOR FAMILY HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN-ELHILLALI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-271-5593
Mailing Address - Street 1:507 DENNIS MAGRUDER DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2110
Mailing Address - Country:US
Mailing Address - Phone:202-271-5593
Mailing Address - Fax:
Practice Address - Street 1:507 DENNIS MAGRUDER DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-2110
Practice Address - Country:US
Practice Address - Phone:202-271-5593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty