Provider Demographics
NPI:1255740775
Name:HOME SAFETY INNOVATIONS L.L.C.
Entity type:Organization
Organization Name:HOME SAFETY INNOVATIONS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHRENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-379-4439
Mailing Address - Street 1:500 RUSSELL DR W
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-8845
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 RUSSELL DR W
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-8845
Practice Address - Country:US
Practice Address - Phone:920-379-4439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5309-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty