Healthcare Provider Details

I. General information

NPI: 1942169404
Provider Name (Legal Business Name): A SAFE SPACE TO HEAL, L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 LOMAS BLVD NW
ALBUQUERQUE NM
87102-1945
US

IV. Provider business mailing address

3167 SAN MATEO BLVD NE # 132
ALBUQUERQUE NM
87110-1921
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-4561
  • Fax:
Mailing address:
  • Phone: 505-226-4561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLA CUADERES
Title or Position: OWNER
Credential: LCSW
Phone: 505-226-4561