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General NPI Number Information
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NPI Number | 1508320276
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Entity Type | Organization
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Legal Business Name | HOME CARE SERVICES LAKESHORE, LLC
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 800 E ELLIS RD STE 534
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City | NORTON SHORES
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State | MI
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Zip | 49441-5622
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Country | US
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Telephone | 616-430-8744
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Fax | 616-239-3001
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Provider Business Mailing Address
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Address Line | 800 E ELLIS RD STE 534
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City | NORTON SHORES
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State | MI
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Zip | 49441-5622
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Country | US
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Telephone | 616-430-8744
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Fax | 616-239-3001
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Authorized Official
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Title or Position | MEMBER
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Name | JEREMY FELLOWS
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Credential |
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Telephone | 616-328-6680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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