MEDICARE: WEST MICHIGAN HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1386496610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST MICHIGAN HOME CARE LLC

Provider Business Mailing Address
First Line	:	3107 BLUE SPRUCE CT SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49512-2872
Country	:	US
Telephone Number	:	616-219-5543
Fax Number	:

Provider Business Practice Location Address
First Line	:	3107 BLUE SPRUCE CT SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49512-2872
Country	:	US
Telephone Number	:	616-219-5543
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	KRISHNA B BISTA
Credential	:
Telephone Number	:	616-219-5543

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	01/14/2026

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