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General NPI Number Information
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NPI Number | 1881319093
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Entity Type | Organization
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Legal Business Name | ADAPTIFY HOME SAFETY SOLUTIONS LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 19120 MYSTIQUE DR
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City | CORCORAN
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State | MN
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Zip | 55340-9586
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Country | US
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Telephone | 320-293-3205
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Fax |
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Provider Business Mailing Address
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Address Line | 19120 MYSTIQUE DR
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City | CORCORAN
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State | MN
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Zip | 55340-9586
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Country | US
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Telephone | 320-293-3205
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATASHA LARSON
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Credential | OTR/L
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Telephone | 320-293-3205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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