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General NPI Number Information
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NPI Number | 1598485922
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Entity Type | Organization
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Legal Business Name | HOME SAFE HOME MICHIGAN, INC.
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 2290 28TH ST SW STE B
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City | WYOMING
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State | MI
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Zip | 49519-2305
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Country | US
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Telephone | 616-226-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 2290 28TH ST SW STE B
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City | WYOMING
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State | MI
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Zip | 49519-2305
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Country | US
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Telephone | 616-226-5577
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA DIETZ
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Credential | OTR
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Telephone | 616-262-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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