Healthcare Provider Details

I. General information

NPI: 1821682873
Provider Name (Legal Business Name): LANETTE'S SAFE HAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2021
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15700 W 10 MILE RD STE 108
SOUTHFIELD MI
48075-2100
US

IV. Provider business mailing address

15700 W 10 MILE RD STE 108
SOUTHFIELD MI
48075-2100
US

V. Phone/Fax

Practice location:
  • Phone: 313-622-8366
  • Fax:
Mailing address:
  • Phone: 248-809-6167
  • Fax: 248-450-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LANETTEL GRIFFIN
Title or Position: OWNER
Credential:
Phone: 313-622-8366