Healthcare Provider Details

I. General information

NPI: 1992558043
Provider Name (Legal Business Name): FRONT PORCH LIVING HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 LANCASTER DR
MANITOU BEACH MI
49253-9106
US

IV. Provider business mailing address

PO BOX 143
MANITOU BEACH MI
49253-0143
US

V. Phone/Fax

Practice location:
  • Phone: 517-206-2394
  • Fax:
Mailing address:
  • Phone: 517-206-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY KAY GRIEWAHN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 517-206-2394