Healthcare Provider Details

I. General information

NPI: 1801753017
Provider Name (Legal Business Name): SAFENEST LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 1/2 W 64TH ST
LOS ANGELES CA
90047-1946
US

IV. Provider business mailing address

PO BOX 11562
SAN BERNARDINO CA
92423-1562
US

V. Phone/Fax

Practice location:
  • Phone: 310-776-5858
  • Fax:
Mailing address:
  • Phone: 310-776-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. SIRRAH ESTELLE
Title or Position: OWNER
Credential:
Phone: 310-776-5858