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General NPI Number Information
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NPI Number | 1578432969
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Entity Type | Organization
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Legal Business Name | SAFE ROOTS LIVING SOLUTIONS
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 2323 STARK ST
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City | COLUMBIA
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State | SC
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Zip | 29205-1065
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Country | US
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Telephone | 702-670-2922
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Fax |
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Provider Business Mailing Address
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Address Line | 9153 TWO NOTCH RD STE C11
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City | COLUMBIA
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State | SC
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Zip | 29223-5853
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Country | US
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Telephone | 702-670-2922
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. JERRIKA SCOTT
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Credential |
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Telephone | 702-760-2922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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