NPIMap

Organization Active NPI

Living Roots LLC

  • In Home Supportive Care Agency
  • Grand Rapids, MI
National Provider Identifier
1629467436
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
LIVING ROOTS LLC
Practice address
2850 Thornhills Ave SE
Suite a
Grand Rapids, MI 49546-7120
Phone
(616) 575-8519
NPI assigned
Jan 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Brian Wilson
Title
Owner/Manager
Phone
(616) 575-8519

Specialties & licenses 1

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

Addresses

Primary practice location

2850 Thornhills Ave SE
Suite a
Grand Rapids, MI 49546-7120

Mailing address

2850 Thornhills Ave SE
Suite a
Grand Rapids, MI 49546-7120
Phone (616) 575-8519

National Provider Directory

National Provider Directory
Tax ID family
Leaves Personal Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2850 Thornhills Ave SE
Ste A
Grand Rapids, MI 49546
Phone (616) 575-8519

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1629467436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 THORNHILLS AVE SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467120",
            "telephone_number": "616-575-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 THORNHILLS AVE SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467120",
            "telephone_number": "616-575-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING ROOTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "616-575-8519"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 16, 2015; 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.