Healthcare Provider Details

I. General information

NPI: 1639074826
Provider Name (Legal Business Name): NURU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 RIDGEWOOD DR
JENISON MI
49428-7922
US

IV. Provider business mailing address

4620 RESTMOR ST SW
GRANDVILLE MI
49418-2235
US

V. Phone/Fax

Practice location:
  • Phone: 616-516-3652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: BEATA MPESHA
Title or Position: PARTNER
Credential:
Phone: 616-856-0163