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Organization

HOME CONNECTION THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAUREN VANDERLAAN MS, OTR/L, CCM (MANAGING MEMBER / OWNER)
(616) 890-8660
Entity
Organization

Contact information

Practice address
1232 GRISWOLD ST SE, GRAND RAPIDS, MI 49507-3815
(616) 890-8660
Mailing address
1232 GRISWOLD ST SE, GRAND RAPIDS, MI 49507-3815
(616) 890-8660

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265005151
GROUP NPI
MI
Enumeration date
07/20/2021
Last updated
08/23/2024
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