Healthcare Provider Details

I. General information

NPI: 1821946245
Provider Name (Legal Business Name): WANDA'S BLESSED HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 MONROE AVE NW
GRAND RAPIDS MI
49503-6211
US

IV. Provider business mailing address

99 MONROE AVE NW
GRAND RAPIDS MI
49503-6211
US

V. Phone/Fax

Practice location:
  • Phone: 800-866-7886
  • Fax:
Mailing address:
  • Phone: 800-866-7886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TENIKA LEWIS
Title or Position: CEO
Credential:
Phone: 616-856-3922