Healthcare Provider Details
I. General information
NPI: 1497267884
Provider Name (Legal Business Name): ROOTED IN LOVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2017
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2029 S ELMS RD STE 101
SWARTZ CREEK MI
48473-9766
US
IV. Provider business mailing address
10029 NICHOLS RD
MONTROSE MI
48457-9173
US
V. Phone/Fax
- Phone: 810-285-8429
- Fax: 810-204-4950
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | 6401014779 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | 6401014779 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | C-03160 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | 6401014779 |
| License Number State | MI |
VIII. Authorized Official
Name:
SAMANTHA
PILLOW
Title or Position: OWNER/DIRECTOR
Credential: LPC, CAADC, NCC, ACS
Phone: 810-285-8429