MEDICARE: SAFE SPACE HOME CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency
3	253Z00000X	In Home Supportive Care Agency
4	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1912854589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE SPACE HOME CARE, LLC

Provider Business Mailing Address
First Line	:	5236 MARSH BUTTE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1624
Country	:	US
Telephone Number	:	702-847-9295
Fax Number	:

Provider Business Practice Location Address
First Line	:	5236 MARSH BUTTE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1624
Country	:	US
Telephone Number	:	702-847-9295
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ ADMINISTRATOR
Name	:	ANTOINETTE CHAVON MINOR
Credential	:
Telephone Number	:	702-847-9295

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/18/2026

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