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General NPI Number Information
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NPI Number | 1578427175
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Entity Type | Organization
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Legal Business Name | ROOTED HOME SAFETY SERVICES, LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 22205 60TH AVE
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City | MATTAWAN
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State | MI
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Zip | 49071-9527
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Country | US
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Telephone | 269-280-8899
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Fax |
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Provider Business Mailing Address
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Address Line | 22205 60TH AVE
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City | MATTAWAN
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State | MI
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Zip | 49071-9527
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Country | US
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Telephone | 269-280-8899
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MARQUES RAYFORD
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Credential | RN
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Telephone | 269-280-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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