A Grand Rapids Senior Social Exchange and Adult Day Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

A GRAND RAPIDS SENIOR SOCIAL EXCHANGE AND ADULT DAY CENTER

Practice address

3212 Eastern Ave SE
Grand Rapids, MI 49508

Phone

(616) 329-4101

NPI assigned

Jan 14, 2018

Last updated

Jul 2, 2018By 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. Jodie Lynn Robertson, NANPI 1699385740

Title

Owner

Phone

(616) 329-4101

Specialties & licenses 3

Addresses

Locations

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.

• Jodie Lynn Robertson

  • Prosthetist
  • Grand Rapids, MI
  • NPI 1699385740
  NPD Authorized official

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

{
    "created_epoch": "1515888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1881102788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7004",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495107004",
            "telephone_number": "616-329-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49508",
            "telephone_number": "616-329-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A GRAND RAPIDS SENIOR SOCIAL EXCHANGE AND ADULT DAY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-14",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-329-4101",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.