Traverse City Residentia Lcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

9674527 Issued in MI

Legal business name

TRAVERSE CITY RESIDENTIA LCARE, LLC

Practice address

176 Island View Dr
Traverse City, MI 49696-9313

Phone

(231) 313-9633

NPI assigned

Jan 8, 2014

Last updated

Jan 8, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Helena (Sam Kay Evans, CAREGIVER

Title

Owner of Agency/Manager/Billing

Phone

(231) 313-9633

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Helena Kay Evans, R. A

  • Home Health Aide
  • Traverse, MI
  • NPI 1831526748
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1356763478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 ISLAND VIEW DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496969313",
            "telephone_number": "231-313-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 ISLAND VIEW DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496969313",
            "telephone_number": "231-313-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVERSE CITY RESIDENTIA LCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "HELENA (SAM",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER OF AGENCY/MANAGER/BILLING",
        "authorized_official_telephone_number": "231-313-9633",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CAREGIVER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": "9674527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9674527",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traverse City Medical LLC
• Traverse City Opco Group, LLC (Medilodge of Traverse City)
• Traverse City Opco, LLC (The Villa at Traverse Point)
• Traverse City Ophthalmology PLLC (Traverse City Eye)
• Traverse City Orthopedics Physical Therapy PC
• Traverse City Teen Counseling
• Traverse City Uscg Phcy
• Traverse Dental Associates, PLLC
• Traverse Geriatric Village, Inc (bortz health care of traverse)
• Traverse Health Clinic and Coalition (Traverse Health Clinic Pharmacy)

• Home Health Agency in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.