Healthcare Provider Details

I. General information

NPI: 1629286562
Provider Name (Legal Business Name): HOME CARE SERVICE STAFFING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1077 LEONARD ST NE
GRAND RAPIDS MI
49503-1261
US

IV. Provider business mailing address

1077 LEONARD ST NE
GRAND RAPIDS MI
49503-1261
US

V. Phone/Fax

Practice location:
  • Phone: 616-454-9844
  • Fax:
Mailing address:
  • Phone: 616-454-9844
  • 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: LYNETTE JEAN DYKHOUSE
Title or Position: OWNER
Credential:
Phone: 616-454-9844