HOLLAND HOME (NPI# 1033287792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033287792 |
| Entity Type | Organization |
| Organization Name | HOLLAND HOME |
| Practice Address |
2100 Raybrook St Se Suite 300 Grand Rapids MI 49546-5783 |
| Practice Telephone | 6162355000 |
| Practice Fax Number | 6162355680 |
| Mailing Telephone | 6162355000 |
| Mailing Fax Number | 6162355680 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID TIESENGA (CFO) |
| Authorized Official Telephone | 6162355035 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| X | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972557460 | Holland Home | Skilled Nursing Facility | 1450 East Fulton, Grand Rapids, MI 49503-3854 | 2006-05-20 |
| 1174577761 | Holland Home | Skilled Nursing Facility | 2589 44th Street, Kentwood, MI 49512-3877 | 2006-05-19 |
| 1396799987 | Holland Home | Skilled Nursing Facility | 2121 Raybrook St Se, Grand Rapids, MI 49546-5793 | 2006-05-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | HOLLAND HOME, LLC | 407 Janet St, Tahlequah, OK 74464 |
| System for Award Management (SAM) Entities | HOLLAND HOMECARE LLC | 95 Lempa Rd, Southampton, PA 18966-2413 |
| Colorado Business Entities | Holland Homes LLC | 3606 S Depew St, 304, Lakewood, CO 80235 |
| Washington State Corporations | HOLLAND HOMES NORTHWEST LLC | 16108 275th St E, Graham, WA 98338-8763 |
| System for Award Management (SAM) Entities | HOLLAND HOMESTEAD RANCH, LLC | 725 Cottonwood Creek Rd, Plains, MT 59859 |
| Street Address |
2100 RAYBROOK ST SE SUITE 300 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-5783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710931308 | Atrio Home Health | Home Health | 2100 Raybrook St Se, Ste 303, Grand Rapids, MI 49546-5783 | 2006-05-19 |
| 1043839111 | Emily L Page | Nurse Practitioner | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2020-04-09 |
| 1992278113 | Julie Marie Ball | Social Worker | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2019-01-10 |
| 1164995049 | Jeanne Marie Burns | Occupational Therapist | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2019-01-03 |
| 1861964389 | Karen Elizabeth Vanderploeg | Speech-Language Pathologist | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2018-12-21 |
| 1942772579 | Rachael Lynn Reimink | Occupational Therapist | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2018-12-20 |
| 1063984862 | Kellie Marie Palmbos | Social Worker | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2018-12-19 |
| 1750853644 | Cheryl A Kaltz | Occupational Therapist | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2018-12-18 |
| 1669944559 | Christine Lynn Fraser-lee | Occupational Therapist | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2018-12-18 |
| 1013489905 | Kristie Jo Parker | Occupational Therapist | 2100 Raybrook St Se, Grand Rapids, MI 49546-7759 | 2018-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1285290197 | The Emeralds At Grand Rapids Assisted Living LLC | Assisted Living Facility | 2815 S Highway 169, Grand Rapids, MN 55744-9532 | 2019-05-15 |
| 1023587227 | Northwoods Villa Inc. 2 | Assisted Living Facility | 1200 Gunn Rd, Grand Rapids, MN 55744-9212 | 2018-11-16 |
| 1588176432 | Brookstone Manor, Inc. | Assisted Living Facility | 722 N Pokegama Ave, Grand Rapids, MN 55744-2669 | 2017-11-01 |
| 1144769506 | Resolute Adult Living Facility | Assisted Living Facility | 1414 Eastern Ave Se, Grand Rapids, MI 49507-2024 | 2017-02-18 |
| 1548667694 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 Sw 11th Ave, Grand Rapids, MN 55744-3562 | 2014-12-04 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1720350341 | Christian Rest Home Association | Assisted Living Facility | 1010 Edison Ave Nw, Grand Rapids, MI 49504-3918 | 2012-01-27 |
| 1396016796 | Northview Care Corp. | Assisted Living Facility | 3740 Richton Ave Ne, Grand Rapids, MI 49525-2463 | 2012-01-18 |
| 1629238878 | Samaritas | Assisted Living Facility | 1900 32nd St Se, Grand Rapids, MI 49508-7908 | 2008-06-11 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on HOLLAND HOME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.