HOLLAND HOME NPI 1972557460

NPI Information

  • NPI: 1972557460
  • Provider Name: HOLLAND HOME
  • Classification: Skilled Nursing Facility - 314000000X
  • Entity Type: Organization
  • Other Name: HOLLAND HOME - FULTON MANOR
  • Address: 1450 EAST FULTON
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 643-2600

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NPI Details

HOLLAND HOME is a skilled nursing facility in Grand Rapids, MI. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. HOLLAND HOME NPI is 1972557460. The provider is registered as an organization entity type.
The provider Other Name Is Holland Home - Fulton Manor.

The provider's business location address is:

1450 EAST FULTON
GRAND RAPIDS, MI
ZIP 49503-854
Phone: (616) 643-2600
Fax: (616) 643-2623

The provider's authorized official is David Tiesenga .
The authorized official title is Cfo and has the following contact phone number (616) 235-5035.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 3/10/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1314000000XSkilled Nursing Facility14196MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12081311MEDICAIDMICHIGAN
2235435MEDICARE OSCAR/CERTIFICATION
309887OTHERBCBS OF MICHIGAN

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: 3/30/2025

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