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Organization

CYCLE OF LIFE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THERESA LATRICE WILLIAMS (MEMBER)
(616) 835-2139
Entity
Organization

Contact information

Practice address
740 32ND ST SE, WYOMING, MI 49548-2329
(616) 608-3341
(616) 608-3693
Mailing address
740 32ND ST SE, WYOMING, MI 49548-2329
(616) 608-3341
(616) 608-3693

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
163W00000X
Registered Nurse
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
208VP0014X
Interventional Pain Medicine Physician
224Z00000X
Occupational Therapy Assistant
225200000X
Physical Therapy Assistant
2278H0200X
Home Health Certified Respiratory Therapist
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
Primary
253Z00000X
In Home Supportive Care Agency
261QA0600X
Adult Day Care Clinic/Center
343900000X
Non-emergency Medical Transport (VAN)
363L00000X
Nurse Practitioner

Other

Enumeration date
10/26/2017
Last updated
12/09/2019
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