Provider Demographics
NPI:1104589688
Name:LIFE AT HOME SAFETY SERVICES, LLC
Entity type:Organization
Organization Name:LIFE AT HOME SAFETY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ORTZOW
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:510-301-1096
Mailing Address - Street 1:5724 MEDALLION CT
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-1708
Mailing Address - Country:US
Mailing Address - Phone:510-301-1096
Mailing Address - Fax:
Practice Address - Street 1:5724 MEDALLION CT
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-1708
Practice Address - Country:US
Practice Address - Phone:510-301-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty