Provider Demographics
NPI:1902937717
Name:SAFE, INCORPORATED
Entity Type:Organization
Organization Name:SAFE, INCORPORATED
Other - Org Name:VALIA HEALTH RESOURCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DRAKE
Authorized Official - Last Name:EWBANK
Authorized Official - Suffix:
Authorized Official - Credentials:QMHA
Authorized Official - Phone:541-988-1025
Mailing Address - Street 1:POST BOX 1543
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-4575
Mailing Address - Country:US
Mailing Address - Phone:541-988-1025
Mailing Address - Fax:541-988-1022
Practice Address - Street 1:175 W B ST
Practice Address - Street 2:BLDG I
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477
Practice Address - Country:US
Practice Address - Phone:541-988-1025
Practice Address - Fax:541-988-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR241382Medicaid