# MANAGED SENIOR CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114314366
- **Authorized official:** MRS. DANNA GOMEZ (CO-OWNER)
- **Authorized official phone:** (616) 234-0190

## Contact information

- **Practice address:** 625 SPRING AVE NE, GRAND RAPIDS, MI 49503-1903
- **Practice address phone:** (616) 234-0190
- **Practice address fax:** (866) 289-0994
- **Mailing address:** PO BOX 140288, GRAND RAPIDS, MI 49514-0288
- **Mailing address phone:** (616) 234-0190
- **Mailing address fax:** (866) 289-0994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 347C00000X | Private Vehicle | — | NULL | — |

## Other

- **Enumeration date:** 04/24/2015
- **Last updated:** 04/24/2015