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COVENANT ENABLING RESIDENCES OF MICHIGAN NPI 1700314564


NPI Information

NPI: 1700314564
Provider Name: COVENANT ENABLING RESIDENCES OF MICHIGAN

Doing Business As: COVENANT ABILITY NETWORK OF MICHIGAN

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 23D1028323

Address:
340 THORNRIDGE CT NW
GRAND RAPIDS, MI
ZIP 49504
Phone: (616) 272-4984
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COVENANT ENABLING RESIDENCES OF MICHIGAN is an adult care home custodial care facility in Grand Rapids, MI. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. COVENANT ENABLING RESIDENCES OF MICHIGAN NPI is 1700314564. The provider is registered as an organization entity type.
The provider Is Doing Business As Covenant Ability Network Of Michigan.

The provider's business location address is:

340 THORNRIDGE CT NW
GRAND RAPIDS, MI
ZIP 49504-887
Phone: (616) 272-4984

The provider's authorized official is Rick J Larman .
The authorized official title is Executive Director and has the following contact phone number (616) 340-5942.

The CLIA number assigned to this NPI record is 23D1028323 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2017 and was last updated on 1/29/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care HomeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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