Organization
LIVING ROOTS LLC
Active
Other names
Leaves Personal Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN WILSON (OWNER/MANAGER)
(616) 575-8519
Entity
Organization
Contact information
Practice address
3980 CHICAGO DR SW, SUITE 100, GRANDVILLE, MI 49418-1392
(616) 575-8519
(616) 575-9078
Mailing address
3980 CHICAGO DR SW, SUITE 100, GRANDVILLE, MI 49418-1392
(616) 575-8519
(616) 575-9078
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/18/2014
Last updated
05/25/2016
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