Organization
COMMUNITY
Active
Parent organization
COMMUNITY
Other names
community, community
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY
Authorized official
RAEKESHA MCMILLIAN ETC (OWNER)
(616) 427-4570
Entity
Organization
Contact information
Practice address
225 CORINNE ST SW, GRAND RAPIDS, MI 49507-1536
(616) 427-4570
Mailing address
1232 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49507-1923
(616) 427-4570
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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