Healthcare Provider Details
I. General information
NPI: 1962337022
Provider Name (Legal Business Name): SAFE SPACE CAROLINAS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
173 COLUMBIA ST UNIT A
CHESTER SC
29706-2924
US
IV. Provider business mailing address
173 COLUMBIA ST UNIT A
CHESTER SC
29706-2924
US
V. Phone/Fax
- Phone: 803-592-6807
- Fax:
- Phone: 803-592-6807
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONIQUE
SAUNDERS
Title or Position: FOUNDER
Credential:
Phone: 718-541-4628