Provider Demographics
NPI:1407870009
Name:HOMEBOUND WELLNESS SOLUTIONS, P.C.
Entity Type:Organization
Organization Name:HOMEBOUND WELLNESS SOLUTIONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSEMA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-457-7735
Mailing Address - Street 1:5828 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-1958
Mailing Address - Country:US
Mailing Address - Phone:231-457-7735
Mailing Address - Fax:231-788-3956
Practice Address - Street 1:5828 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-1958
Practice Address - Country:US
Practice Address - Phone:231-457-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101009504OtherMEDICAL LICENSE
MI5611066OtherBCBS OF MICHIGAN
MI5611066OtherCAQH
MI5611066OtherCAQH
MI5101009504OtherMEDICAL LICENSE