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General NPI Number Information
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NPI Number | 1619197407
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Entity Type | Organization
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Legal Business Name | GRAND RAPIDS HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 3033 ORCHARD VISTA DR SE SUITE 311
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7077
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Country | US
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Telephone | 616-957-9914
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Fax | 616-957-9900
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Provider Business Mailing Address
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Address Line | 3033 ORCHARD VISTA DR SE SUITE 311
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7077
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Country | US
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Telephone | 616-957-9914
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Fax | 616-957-9900
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Authorized Official
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Title or Position | OWNER
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Name | MR. MAHMOUD ALDWAKE
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Credential | PT
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Telephone | 313-595-0737
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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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