Healthcare Provider Details

I. General information

NPI: 1184248114
Provider Name (Legal Business Name): COMPREHENSIVE HEALTH AND HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 BURTON ST SE
GRAND RAPIDS MI
49546-4804
US

IV. Provider business mailing address

2505 BURTON ST SE
GRAND RAPIDS MI
49546-4804
US

V. Phone/Fax

Practice location:
  • Phone: 616-729-0303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: SUMMER WILLIAMS
Title or Position: OWNER
Credential:
Phone: 616-729-0303