Healthcare Provider Details

I. General information

NPI: 1992645618
Provider Name (Legal Business Name): GROVE HOME CARE MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MONROE AVE NW STE 400
GRAND RAPIDS MI
49503-2293
US

IV. Provider business mailing address

PO BOX 267
LAKEWOOD NJ
08701-0267
US

V. Phone/Fax

Practice location:
  • Phone: 732-614-2770
  • Fax:
Mailing address:
  • Phone: 732-614-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NAFTALI JOSEPH FREUND
Title or Position: OWNER
Credential:
Phone: 732-614-2770