Healthcare Provider Details

I. General information

NPI: 1558974303
Provider Name (Legal Business Name): HOME FIT HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2020
Last Update Date: 08/30/2020
Certification Date: 08/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 WASHINGTON ST
WINNER SD
57580-1932
US

IV. Provider business mailing address

313 WASHINGTON ST
WINNER SD
57580-1932
US

V. Phone/Fax

Practice location:
  • Phone: 860-306-6834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA MARIE SOJA
Title or Position: OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 860-306-6834