Healthcare Provider Details

I. General information

NPI: 1992935308
Provider Name (Legal Business Name): SAFA CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 S PADDOCK ST
PONTIAC MI
48342-2622
US

IV. Provider business mailing address

4787 SHORELINE BLVD
WATERFORD MI
48329-1659
US

V. Phone/Fax

Practice location:
  • Phone: 248-499-3655
  • Fax:
Mailing address:
  • Phone: 248-623-4999
  • Fax: 246-623-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6801059815
License Number StateMI

VIII. Authorized Official

Name: DR. CLYDE ALEXANDER
Title or Position: CLINICAL SOCIAL WORKER
Credential: LMSW
Phone: 248-623-4999