Healthcare Provider Details

I. General information

NPI: 1639082126
Provider Name (Legal Business Name): THE SAFE AND SECURE COMMUNITY HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 E MONTEROSA ST
PHOENIX AZ
85016-5803
US

IV. Provider business mailing address

3131 E MONTEROSA ST
PHOENIX AZ
85016-5803
US

V. Phone/Fax

Practice location:
  • Phone: 702-237-9348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SMITH
Title or Position: OWNER
Credential:
Phone: 360-471-1486