# CYCLE OF LIFE SUPPORT COMMUNITY HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cycle of Life Support CHS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023645884
- **Authorized official:** THERESA WILLIAMS (OPERATIONS MANAGER)
- **Authorized official phone:** (720) 441-3141

## Contact information

- **Practice address:** 1520 E GANSON ST, JACKSON, MI 49202-3530
- **Practice address phone:** (616) 275-8930
- **Practice address fax:** (616) 608-3693
- **Mailing address:** 717 PRINCE ST SE, GRAND RAPIDS, MI 49507-1241
- **Mailing address phone:** (720) 441-3141
- **Mailing address fax:** (616) 608-3693

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251F00000X | Home Infusion Agency | — | NULL | — |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 03/23/2020
- **Last updated:** 03/24/2020