Healthcare Provider Details
I. General information
NPI: 1952179640
Provider Name (Legal Business Name): G.I.N.A.S GIVING INFORMATION NETWORKING ADVOCACY & SUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2023
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2487 FOX RUN RD SW APT 5
WYOMING MI
49519-4115
US
IV. Provider business mailing address
3976 RESERVE DR SW
WYOMING MI
49418-7334
US
V. Phone/Fax
- Phone: 616-416-5091
- Fax:
- Phone: 616-389-3469
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REGINA
KING
Title or Position: COORDINATOR
Credential:
Phone: 616-389-3469