Provider Demographics
NPI:1427678655
Name:SAFEPOINTE LLC
Entity type:Organization
Organization Name:SAFEPOINTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:
Authorized Official - First Name:KORISMA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-531-8882
Mailing Address - Street 1:41600 N BELLRIDGE DR APT B913
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-4558
Mailing Address - Country:US
Mailing Address - Phone:734-531-8882
Mailing Address - Fax:
Practice Address - Street 1:240 NICKELS ARC
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2410
Practice Address - Country:US
Practice Address - Phone:734-531-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty