Provider Demographics
NPI:1942619259
Name:LANE IN HOME THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:LANE IN HOME THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:OTL
Authorized Official - Phone:248-227-5583
Mailing Address - Street 1:5514 LANCASTER LN
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-2887
Mailing Address - Country:US
Mailing Address - Phone:248-227-5583
Mailing Address - Fax:248-387-3233
Practice Address - Street 1:5514 LANCASTER LN
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-2887
Practice Address - Country:US
Practice Address - Phone:248-227-5583
Practice Address - Fax:248-387-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002641251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health