Provider Demographics
NPI:1982282984
Name:ROAD TO REDEMPTION LLC
Entity Type:Organization
Organization Name:ROAD TO REDEMPTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARTANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-397-0899
Mailing Address - Street 1:6394 DEW POINT CT SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-7349
Mailing Address - Country:US
Mailing Address - Phone:269-397-0899
Mailing Address - Fax:
Practice Address - Street 1:6394 DEW POINT CT SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-7349
Practice Address - Country:US
Practice Address - Phone:269-397-0899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health