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General NPI Number Information
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NPI Number | 1609577261
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Entity Type | Organization
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Legal Business Name | RL HOMES LLC
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Dates
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Enumeration Date | 03/10/2023
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 445 MAETHY ST SE
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City | WYOMING
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State | MI
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Zip | 49548-1219
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Country | US
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Telephone | 616-947-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 6670 KALAMAZOO AVE SE STE D126
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-7856
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Country | US
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Telephone | 616-947-4900
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. RASHIDA MITCHNER
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Credential |
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Telephone | 616-947-4900
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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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