Organization Active NPI

Community

  • In Home Supportive Care Agency
  • Grand Rapids, MI
National Provider Identifier
1396404240
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
COMMUNITY
Practice address
225 Corinne St SW
Grand Rapids, MI 49507-1536
Phone
(616) 427-4570
NPI assigned
Dec 8, 2021
Organization subpart
Yes
Parent organization
COMMUNITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Raekesha McMillian, ETCNPI 1053837922
Title
Owner
Phone
(616) 427-4570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

225 Corinne St SW
Grand Rapids, MI 49507-1536

Mailing address

1232 Kalamazoo Ave SE
Grand Rapids, MI 49507-1923
Phone (616) 427-4570

Other names 1

  • community Other name

National Provider Directory

National Provider Directory
Part of
Community

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1396404240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071923",
            "telephone_number": "616-427-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CORINNE ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495071536",
            "telephone_number": "616-427-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "MCMILLIAN",
        "authorized_official_first_name": "RAEKESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-427-4570",
        "authorized_official_credential": "ETC"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "community",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.