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Organization
HOLLAND HOME
Active
Organization
HOLLAND HOME
Active
Parent organization
HOLLAND HOME
Other names
Holland Home - Raybrook Manor
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOLLAND HOME
Authorized official
MR. ADAM KINDER (CFO)
(616) 235-5015
Entity
Organization
Contact information
Practice address
2121 RAYBROOK ST SE, GRAND RAPIDS, MI 49546-5793
(616) 235-5002
(616) 235-5088
Mailing address
2121 RAYBROOK ST SE, GRAND RAPIDS, MI 49546-5793
(616) 235-5002
(616) 235-5088
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
14208
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09891
BCBS OF MICHIGAN
—
05
—
2084260
—
MI
Enumeration date
05/19/2006
Last updated
04/29/2021
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