Healthcare Provider Details

I. General information

NPI: 1962976175
Provider Name (Legal Business Name): CAREOLOGY HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 44TH ST SW STE 100
GRANDVILLE MI
49418-2685
US

IV. Provider business mailing address

2855 44TH ST SW STE 100
GRANDVILLE MI
49418-2685
US

V. Phone/Fax

Practice location:
  • Phone: 616-208-1662
  • Fax: 616-208-1690
Mailing address:
  • Phone: 616-208-1662
  • Fax: 616-208-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA DOUGLAS MITCHELL
Title or Position: OWNER
Credential:
Phone: 616-208-1662