Organization
LIVING ROOTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WILSON (OWNER/MANAGER)
(616) 575-8519
Entity
Organization
Contact information
Practice address
2850 THORNHILLS AVE SE, SUITE A, GRAND RAPIDS, MI 49546-7120
(616) 575-8519
Mailing address
2850 THORNHILLS AVE SE, SUITE A, GRAND RAPIDS, MI 49546-7120
(616) 575-8519
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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