Healthcare Provider Details

I. General information

NPI: 1114836467
Provider Name (Legal Business Name): 517 LAWN CAREGIVERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MARKLEY PL
LANSING MI
48910-2865
US

IV. Provider business mailing address

2400 MARKLEY PL
LANSING MI
48910-2865
US

V. Phone/Fax

Practice location:
  • Phone: 517-490-3146
  • Fax:
Mailing address:
  • Phone: 517-490-3146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: MR. DERRICK JARRELL BLOCKER
Title or Position: DIRECTOR
Credential:
Phone: 517-490-3146