Provider Demographics
| NPI: | 1407535461 |
|---|---|
| Name: | YOUR SAFE PLACE LLC |
| Entity type: | Organization |
| Organization Name: | YOUR SAFE PLACE LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SHARAIN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | JOHNSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 832-755-5457 |
| Mailing Address - Street 1: | 2626 S LOOP W STE 425 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77054-2652 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-635-9760 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2626 S LOOP W STE 425 |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77054-2652 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 713-635-9760 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-07-17 |
| Last Update Date: | 2025-06-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Single Specialty | |
| No | 251B00000X | Agencies | Case Management | Group - Single Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Single Specialty | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Single Specialty | |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care | Group - Single Specialty |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | Group - Multi-Specialty |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | Group - Multi-Specialty |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM3000X | Ambulatory Health Care Facilities | Clinic/Center | Medically Fragile Infants and Children Day Care | |
| No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness | |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child | Group - Multi-Specialty |
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
