Healthcare Provider Details

I. General information

NPI: 1104063510
Provider Name (Legal Business Name): ATTENTIVE CARE COMPANIONS COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 CASCADE RD SE BUILDING #1, SUITE #11
GRAND RAPIDS MI
49546-3666
US

IV. Provider business mailing address

4519 CASCADE RD SE BUILDING #1, SUITE #11
GRAND RAPIDS MI
49546-3666
US

V. Phone/Fax

Practice location:
  • Phone: 616-575-9050
  • Fax:
Mailing address:
  • Phone: 616-575-9050
  • 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: MR. STEVEN T JESNEK
Title or Position: PRESIDENT
Credential:
Phone: 616-575-9050