WEDGWOOD CHRISTIAN SERVICES


Address: 3300 36th St Se, Grand Rapids, MI 49512-2810
Phone: 6169422110

WEDGWOOD CHRISTIAN SERVICES (NPI# 1902997224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902997224
Entity Type Organization
Organization Name WEDGWOOD CHRISTIAN SERVICES
Practice Address 3300 36th St Se
Grand Rapids
MI 49512-2810
Practice Telephone 6169422110
Practice Fax Number 6169420589
Mailing Telephone 6169422110
Mailing Fax Number 6169420589
Enumeration Date 2006-09-28
Last Update Date 2018-10-01
Authorized Official Name JEANNA MARIE RATERINK (CONTRACT MANAGER)
Authorized Official Telephone 6168315627
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities
N 322D00000X Residential Treatment Facility, Emotionally Disturbed Children CI410201226 MI Residential Treatment Facilities
N 322D00000X Residential Treatment Facility, Emotionally Disturbed Children CI410201359 MI Residential Treatment Facilities
N 322D00000X Residential Treatment Facility, Emotionally Disturbed Children CI410201082 MI Residential Treatment Facilities
N 322D00000X Residential Treatment Facility, Emotionally Disturbed Children CICI410201003 MI Residential Treatment Facilities
N 322D00000X Residential Treatment Facility, Emotionally Disturbed Children CI41020150 MI Residential Treatment Facilities
N 3245S0500X Substance Abuse Rehabilitation Facility
Specialization: Substance Abuse Treatment, Children
CI410201502 MI Residential Treatment Facilities
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
100 Buckley St Se, Grand Rapids, MI 495035203 6169422110
1260 Ekhart St Ne, Grand Rapids, MI 495031380 6169422110
12930 James St Ste 210, Holland, MI 494248324 6169422110
21061 19 Mile Rd, Big Rapids, MI 493079267 6169422110
407 S Nelson St, Greenville, MI 488382138 6169422110
910 E Lincoln Ave, Ionia, MI 488461393 6169212110
950 W Norton Ave Ste 301, Muskegon, MI 494414183 6169422110

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1730302308 Wedgwood Christian Services Case Management 3351 36th St Se, Grand Rapids, MI 49512-2809 2007-04-11
1215047667 Wedgwood Christian Services Community/Behavioral Health 3300 36th St Se, Grand Rapids, MI 49512-2810 2006-08-30
1154505337 Wedgwood Christian Services Community/Behavioral Health 3300 36th St Se, Grand Rapids, MI 49512-2810 2007-12-24
1235252750 Wedgwood Christian Services Counselor 300 68th St Se, Grand Rapids, MI 49548-6927 2007-04-09
1972635761 Wedgwood Christian Services Counselor 2520 Eastern Ave Se, Grand Rapids, MI 49507-3633 2007-03-09
1326122516 Wedgwood Christian Services Counselor 3180 Racquet Club Dr, Ste. G, Traverse City, MI 49684-4797 2006-10-24

Office Location

Street Address 3300 36TH ST SE
City GRAND RAPIDS
State MI
Zip Code 49512-2810

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215047667 Wedgwood Christian Services Community/Behavioral Health 3300 36th St Se, Grand Rapids, MI 49512-2810 2006-08-30
1396345005 Khrystal Lewis Behavior Technician 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-10-30
1528675105 Aleah Caizza Behavior Technician 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-09-28
1356958144 Joyce Marie Mason Behavior Technician 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-09-25
1689280638 Aaron Jeremy Ackley Social Worker 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-09-16
1588270417 Hayley Landstra Behavior Technician 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-09-16
1972114288 Ashley Pecott Counselor 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-08-11
1376154856 Zorica Baka Social Worker 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-08-10
1588274336 Jenna Beson Student in an Organized Health Care Education/Training Program 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-08-06
1821608795 Evan Helene Pellow-robbins Social Worker 3300 36th St Se, Grand Rapids, MI 49512-2810 2020-08-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649757071 St. Lukes Primary Care Family Medicine 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 2018-07-27
1013493733 Pharmascript of Michigan Gr LLC Pharmacy 2661 29th St. Se Suite A, Grand Rapids, MI 49512 2018-07-16
1245736040 Cassandra Slater Technician, Other 2925 Breton Rd Se, Grand Rapids, MI 49512 2018-04-02
1235632704 John Mitchell Tanja Occupational Therapist 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 2018-03-12
1952829855 Sarah Harlow Physical Therapist 2951 44th St Se, Kentwood, MI 49512 2017-08-31
1194248815 Melinda Huizenga Registered Nurse 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 2017-07-25
1659812931 Frantzie Pierre Counselor 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 2017-03-20
1104128602 Hope Network Behavioral Health Services Psychiatry & Neurology 3361 36th Street, Grand Rapids, MI 49512 2010-12-03
1518282631 Melanie Anne Hogeterp Social Worker 3180 East Paris Se, Kentwood, MI 49512 2010-03-31
1013147495 Ardean Beth Brock-vanderwall Counselor 2828 Kraft Ave., Grand Rapids, MI 49512 2009-07-20
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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1376862151 Advantage Health/saint Mary's Medical Group Clinic/Center 245 State St Se, Grand Rapids, MI 49503-4328 2010-05-19

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1598319147 Crescent Procedure Center Plc Clinic/Center 30671 Stephenson Hwy Ste A, Madison Heights, MI 48071-1635 2019-07-31
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Competitor

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City GRAND RAPIDS
Zip Code 49512

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Dataset Information

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.

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