Healthcare Provider Details

I. General information

NPI: 1861779209
Provider Name (Legal Business Name): L & L CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5075 CASCADE RD SE SUITE H
GRAND RAPIDS MI
49546-3700
US

IV. Provider business mailing address

5075 CASCADE RD SE SUITE H
GRAND RAPIDS MI
49546-3700
US

V. Phone/Fax

Practice location:
  • Phone: 616-942-9770
  • Fax: 616-828-5047
Mailing address:
  • Phone: 616-942-9770
  • Fax: 616-828-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNON LICENSURE STATE
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberNON LICENSURE STATE
License Number StateMI

VIII. Authorized Official

Name: MARY L MASTAGLIO
Title or Position: OWNER
Credential:
Phone: 616-942-9770