Healthcare Provider Details

I. General information

NPI: 1023317047
Provider Name (Legal Business Name): COMMUNITY HOME CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E BELTLINE AVE SE STE 250
GRAND RAPIDS MI
49506-4364
US

IV. Provider business mailing address

1550 E BELTLINE AVE SE STE 250
GRAND RAPIDS MI
49506-4364
US

V. Phone/Fax

Practice location:
  • Phone: 616-949-3971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RUTH LEESTMA
Title or Position: CEO
Credential:
Phone: 231-744-7700