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General NPI Number Information
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NPI Number | 1265273411
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Entity Type | Organization
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Legal Business Name | SAFE SPACES MENTAL HEALTH
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 1228 SUNSET DR
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City | NORWALK
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State | IA
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Zip | 50211-2401
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Country | US
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Telephone | 515-205-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 SUNSET DR STE D
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City | NORWALK
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State | IA
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Zip | 50211-2401
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Country | US
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Telephone | 515-461-9244
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. SARAH EVIE SCHULLER
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Credential | ARNP, PMHNP-BC
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Telephone | 515-461-9244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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