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General NPI Number Information
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NPI Number | 1023437589
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Entity Type | Organization
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Legal Business Name | SHS OF WEST MICHIGAN, LLC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 1429 WERNER AVE NW
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City | WALKER
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State | MI
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Zip | 49534-2443
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Country | US
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Telephone | 616-234-0190
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Fax | 866-289-0994
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Provider Business Mailing Address
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Address Line | 1429 WERNER AVE NW
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City | WALKER
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State | MI
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Zip | 49534-2443
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Country | US
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Telephone | 616-234-0190
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Fax | 866-289-0994
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA THRUSH
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Credential | LPN
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Telephone | 616-234-0190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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