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General NPI Number Information
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NPI Number | 1790608057
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Entity Type | Organization
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Legal Business Name | A NORTH SIDE HOME CARE EXPERIENCE
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 831 DORCHESTER AVE SW
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4803
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Country | US
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Telephone | 616-334-1148
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33
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City | COMSTOCK PARK
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State | MI
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Zip | 49321
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Country | US
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Telephone | 616-334-1148
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE TAYLOR
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Credential | TAYLOR
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Telephone | 616-334-1148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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