Organization Active NPI

Safespace LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Beaverton, OR
National Provider Identifier
1700619533
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SAFESPACE LLC
Practice address
12655 SW Center St Ste 145
Beaverton, OR 97005-1864
Phone
(619) 510-3230
NPI assigned
Aug 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yared Darcha
Title
Manager
Phone
(971) 762-2087

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

12655 SW Center St Ste 145
Beaverton, OR 97005-1864

Mailing address

12655 SW Center St Ste 145
Beaverton, OR 97005-1864
Phone (971) 762-2089

National Provider Directory

National Provider Directory

Locations

12655 SW Center St
Ste 145
Beaverton, OR 97005
Phone (619) 510-3230

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1700619533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 SW CENTER ST STE 145",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051864",
            "telephone_number": "971-762-2089",
            "fax_number": "971-762-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 SW CENTER ST STE 145",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051864",
            "telephone_number": "619-510-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFESPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "DARCHA",
        "authorized_official_first_name": "YARED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "971-762-2087"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.