Healthcare Provider Details

I. General information

NPI: 1235359761
Provider Name (Legal Business Name): HGA NONPROFIT HOMES, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W WESTERN AVE SUITE 300
MUSKEGON MI
49440-1094
US

IV. Provider business mailing address

500 W WESTERN AVE SUITE 300
MUSKEGON MI
49440-1094
US

V. Phone/Fax

Practice location:
  • Phone: 231-728-3501
  • Fax: 231-722-1931
Mailing address:
  • Phone: 231-728-3501
  • Fax: 231-722-1931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MYRA DUTTON
Title or Position: CEO
Credential: JD
Phone: 231-728-3501