Organization
CYCLE OF LIFE SUPPORT COMMUNITY HEALTH SERVICES LLC
Active
Other names
Cycle of Life Support CHS
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA WILLIAMS (OPERATIONS MANAGER)
(720) 441-3141
Entity
Organization
Contact information
Practice address
1520 E GANSON ST, JACKSON, MI 49202-3530
(616) 275-8930
(616) 608-3693
Mailing address
717 PRINCE ST SE, GRAND RAPIDS, MI 49507-1241
(720) 441-3141
(616) 608-3693
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
163W00000X
Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
03/23/2020
Last updated
03/24/2020
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