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General NPI Number Information
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NPI Number | 1699339143
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Entity Type | Organization
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Legal Business Name | JUST LIKE HOME, LLC
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 330 4TH ST
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City | IONIA
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State | MI
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Zip | 48846-9707
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Country | US
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Telephone | 616-523-4310
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Fax | 616-523-4311
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Provider Business Mailing Address
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Address Line | 330 4TH ST
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City | IONIA
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State | MI
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Zip | 48846-9707
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Country | US
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Telephone | 616-523-4310
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Fax | 616-523-4311
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Authorized Official
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Title or Position | NURSING ADMINISTRATOR
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Name | TRACY HODGKINS
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Credential | LPN
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Telephone | 616-523-4310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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