CCRC OPCO - HOLLAND, LLC (NPI# 1568412690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568412690 |
| Entity Type | Organization |
| Organization Name | CCRC OPCO - HOLLAND, LLC |
| Other Organization Name | THE INN AT FREEDOM VILLAGE |
| Practice Address |
145 Columbia Ave Holland MI 49423-2981 |
| Practice Telephone | 6168207400 |
| Practice Fax Number | 6168207410 |
| Mailing Telephone | 6168207400 |
| Mailing Fax Number | 6168207410 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-10-09 |
| Authorized Official Name | BRYAN RICHARDSON (CAO) |
| Authorized Official Telephone | 6152212250 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROOKDALE SENIOR LIVING INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 704011 | MI | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Inn at Freedom Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245644509 | Ccrc Opco - Holland, LLC | Skilled Nursing Facility | 145 Columbia Ave, Holland, MI 49423-2981 | 2014-06-16 |
| Street Address |
145 COLUMBIA AVE |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-2981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245644509 | Ccrc Opco - Holland, LLC | Skilled Nursing Facility | 145 Columbia Ave, Holland, MI 49423-2981 | 2014-06-16 |
| 1023328697 | Spectrum Health Primary Care Partners | Internal Medicine | 145 Columbia Ave, Holland, MI 49423-2981 | 2010-10-18 |
| 1336450071 | George Jay Hoekstra | Family Medicine | 145 Columbia Ave, # 209, Holland, MI 49423-2983 | 2010-06-28 |
| 1962660001 | Michigan Medical Patient Care | Podiatrist | 145 Columbia Ave, Holland, MI 49423-2981 | 2008-05-27 |
| 1477761195 | Jerry Mcnicoll Gray | Pathology | 145 Columbia Ave, Holland, MI 49423-2987 | 2007-05-18 |
| 1396783858 | Arc Therapy Services LLC | Clinic/Center | 145 Columbia Ave, Holland, MI 49423-2981 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996714 | Ella Rose Marx | Social Worker | 412 Century Lane, Holland, MI 49423 | 2019-08-02 |
| 1245720424 | Amanda Ann Allen | Behavior Technician | 165 Sorrento Drive, Holland, MI 49423 | 2018-05-14 |
| 1588194237 | Emily Amila Geurink | Physical Therapy Assistant | 4037 43rd St, Holland, MI 49423 | 2017-06-15 |
| 1285081737 | Kara Draayer | Nurse Anesthetist, Certified Registered | 25 W 8th St Ste 200, Holland, MI 49423 | 2016-05-14 |
| 1851776413 | Sara Ty | Occupational Therapist | 789 South Meadow Court, Holland, MI 49423 | 2015-07-24 |
| 1508243056 | Andrew Peasley | Chiropractor | 436 Century Ln., Holland, MI 49423 | 2015-05-05 |
| 1437536497 | Deborah Donnelly | Physical Therapy Assistant | 1221 16th Street, Holland, MI 49423 | 2015-04-29 |
| 1366846024 | John Nguyen | Pharmacist | 747 E 16th St, Holland, MI 49423 | 2014-10-09 |
| 1003257817 | Courtney Young | Social Worker | 96 W 15 Street Midtown Center- Arbor Circle, Holland, MI 49423 | 2013-07-09 |
| 1689014391 | Jason Pettet | Acupuncturist | 500 West 17th St., Holland, MI 49423 | 2013-06-26 |
| Find all providers in zip 49423 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366759821 | Matthew Robinson | Skilled Nursing Facility | 9049 Frankfort Rd, Holland, OH 43528-8908 | 2010-09-07 |
| 1235325028 | Tendercare (michigan) Inc. | Skilled Nursing Facility | 1221 E 16th St, Holland, MI 49423-9127 | 2007-09-14 |
| 1942239223 | Resthaven | Skilled Nursing Facility | 280 W 40th St, Holland, MI 49423 | 2006-06-30 |
| 1194766998 | Heartland of Holland Mi LLC | Skilled Nursing Facility | 493 W 32nd St, Holland, MI 49423-7201 | 2006-06-10 |
| 1427096056 | Lutheran Orphans and Old Folks Home At Wolf Creek | Skilled Nursing Facility | 2001 Perrysburg Holland Rd, Holland, OH 43528-7005 | 2006-06-04 |
| 1659373298 | Diakon Lutheran Social Ministries | Skilled Nursing Facility | 280 Middle Holland Road, Holland, PA 18966-4822 | 2005-08-12 |
| 1134747033 | Twining Village Snf Operating Company LLC | Skilled Nursing Facility | 280 Middle Holland Rd, Holland, PA 18966-4822 | 2020-07-08 |
| 1225578727 | Spring Meadow Nursing & Rehabilitation Centre LLC | Skilled Nursing Facility | 1125 Clarion Ave, Holland, OH 43528-8107 | 2017-03-02 |
| 1215473194 | Holland Opco II, LLC | Skilled Nursing Facility | 493 W 32nd St, Holland, MI 49423-7201 | 2017-01-16 |
| 1477940799 | Teresa Alfaro | Skilled Nursing Facility | 1221 E 16th St, Holland, MI 49423-9127 | 2015-04-24 |
| Find all providers in HOLLAND | ||||
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| 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.