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General NPI Number Information
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NPI Number | 1598318560
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Entity Type | Organization
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Legal Business Name | CYCLE OF LIFE LLC
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 740 32ND ST SE
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City | WYOMING
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State | MI
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Zip | 49548-2329
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Country | US
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Telephone | 616-608-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 740 32ND ST SE
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City | WYOMING
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State | MI
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Zip | 49548-2329
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Country | US
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Telephone | 616-608-3341
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | THERESA LATRICE WILLIAMS
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Credential |
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Telephone | 616-608-3341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #10
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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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