Healthcare Provider Details

I. General information

NPI: 1831762921
Provider Name (Legal Business Name): VISITING NURSE SERVICES OF WESTERN MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 CEDAR ST NE
GRAND RAPIDS MI
49503-1375
US

IV. Provider business mailing address

1401 CEDAR ST NE
GRAND RAPIDS MI
49503-1375
US

V. Phone/Fax

Practice location:
  • Phone: 616-486-3900
  • Fax:
Mailing address:
  • Phone: 616-486-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW E COX
Title or Position: CFO
Credential:
Phone: 616-391-1663