Healthcare Provider Details

I. General information

NPI: 1285284174
Provider Name (Legal Business Name): SIMPLY A LOVING TOUCH HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 COLRAIN ST SW
WYOMING MI
49548-1013
US

IV. Provider business mailing address

PO BOX 120097
GRAND RAPIDS MI
49528-0102
US

V. Phone/Fax

Practice location:
  • Phone: 616-288-5448
  • Fax:
Mailing address:
  • Phone: 616-288-5448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health 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
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: KATRINA JONES
Title or Position: OWNER
Credential:
Phone: 616-477-3662