Organization
A SAFE SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY SCOTT GORDON LPC, MS (PRESIDENT)
(678) 558-3930
Entity
Organization
Contact information
Practice address
3342 ROSE RDG, ATLANTA, GA 30340-4074
(678) 558-3930
Mailing address
3342 ROSE RDG, ATLANTA, GA 30340-4074
(678) 558-3930
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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