| Michigan Safe Space Llc | |
|
151 N Shore Dr W Cadillac MI 49601-8208 | |
| (734) 301-7668 | |
| (734) 667-3925 |
| Full Name | Michigan Safe Space Llc |
|---|---|
| Speciality | Social Worker |
| Location | 151 N Shore Dr W, Cadillac, Michigan |
| Authorized Official Name and Position | Chad Allee (OWNER) |
| Authorized Official Contact | 7348456015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Safe Space Llc Po Box 1044 Cadillac MI 49601-6044 Ph: () - | Michigan Safe Space Llc 151 N Shore Dr W Cadillac MI 49601-8208 Ph: (734) 301-7668 |
| NPI Number | 1407571581 |
|---|---|
| Provider Enumeration Date | 10/11/2022 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Medicare PECOS PAC ID | 0446627491 |
|---|---|
| Medicare Enrollment ID | O20221103000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407571581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Chad Michael Allee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457750440 PECOS PAC ID: 9739300237 Enrollment ID: I20141028001448 |
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