1235347089 NPI number — ATTENTIVE CARE COMPANIONS COMPANY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235347089 NPI number — ATTENTIVE CARE COMPANIONS COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATTENTIVE CARE COMPANIONS COMPANY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235347089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4519 CASCADE RD SE
Provider Second Line Business Mailing Address:
BLDG 1, SUITE 11
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49546-3666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-575-9050
Provider Business Mailing Address Fax Number:
616-619-6100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4519 CASCADE RD SE
Provider Second Line Business Practice Location Address:
BLDG 1, SUITE 11
Provider Business Practice Location Address City Name:
GRAND RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49546-3666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-575-9050
Provider Business Practice Location Address Fax Number:
616-619-6100
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JESNEK
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
616-575-9050

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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