Provider Demographics
NPI:1881319093
Name:ADAPTIFY HOME SAFETY SOLUTIONS LLC
Entity type:Organization
Organization Name:ADAPTIFY HOME SAFETY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:320-293-3205
Mailing Address - Street 1:19120 MYSTIQUE DR
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:MN
Mailing Address - Zip Code:55340-9586
Mailing Address - Country:US
Mailing Address - Phone:320-293-3205
Mailing Address - Fax:
Practice Address - Street 1:19120 MYSTIQUE DR
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:MN
Practice Address - Zip Code:55340-9586
Practice Address - Country:US
Practice Address - Phone:320-293-3205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Multi-Specialty
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontologyGroup - Multi-Specialty