Healthcare Provider Details

I. General information

NPI: 1376477489
Provider Name (Legal Business Name): SAFE SPACE OASIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8276 COPPERNAIL WAY
WEST CHESTER OH
45069-1856
US

IV. Provider business mailing address

8276 COPPERNAIL WAY
WEST CHESTER OH
45069-1856
US

V. Phone/Fax

Practice location:
  • Phone: 513-900-7575
  • Fax:
Mailing address:
  • Phone: 513-900-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTIE L STUCKEY
Title or Position: CEO/ PEER SPECIALIST
Credential: CPRS
Phone: 513-900-7575