Provider Demographics
NPI:1598485922
Name:HOME SAFE HOME MICHIGAN, INC.
Entity Type:Organization
Organization Name:HOME SAFE HOME MICHIGAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIETZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:616-262-1222
Mailing Address - Street 1:2290 28TH ST SW STE B
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-2305
Mailing Address - Country:US
Mailing Address - Phone:616-226-5577
Mailing Address - Fax:
Practice Address - Street 1:2290 28TH ST SW STE B
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-2305
Practice Address - Country:US
Practice Address - Phone:616-226-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty