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76TH ST AFC LLC NPI 1366982159


NPI Information

NPI: 1366982159
Provider Name: 76TH ST AFC LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
3554 76TH ST SE
CALEDONIA, MI
ZIP 49316
Phone: (616) 698-6681
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76TH ST AFC LLC is an adult care home custodial care facility in Caledonia, 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. 76TH ST AFC LLC NPI is 1366982159. The provider is registered as an organization entity type.

The provider's business location address is:

3554 76TH ST SE
CALEDONIA, MI
ZIP 49316-113
Phone: (616) 698-6681

The provider's authorized official is Debra Krajewski .
The authorized official title is Licensee/designee and has the following contact phone number (616) 318-1961.

The enumeration date for this NPI number is 2/28/2017 and was last updated on 2/28/2017.


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 HomeAM410285883MICHIGANYes

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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