Healthcare Provider Details

I. General information

NPI: 1346106101
Provider Name (Legal Business Name): NEW SONG COMMUNITY WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16050 WAYNE ST
UNION MI
49130-9637
US

IV. Provider business mailing address

16050 WAYNE ST
UNION MI
49130-9637
US

V. Phone/Fax

Practice location:
  • Phone: 574-248-2485
  • Fax: 574-319-7689
Mailing address:
  • Phone: 574-248-2485
  • Fax: 574-319-7689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: SHANNA STAR GARRIES
Title or Position: OWNER/PROVIDER
Credential: LM, CPM
Phone: 574-248-2485