SEVENTY SIXTH STREET AFC LLC (NPI# 1962773408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962773408 |
| Entity Type | Organization |
| Organization Name | SEVENTY SIXTH STREET AFC LLC |
| Practice Address |
3554 76th St Se Caledonia MI 49316-9113 |
| Mailing Address |
6026 Kalamazoo Ave Se #296 Kentwood MI 49508-7018 |
| Practice Telephone | 6166986681 |
| Practice Fax Number | 6166986681 |
| Mailing Telephone | 6163181961 |
| Mailing Fax Number | 6168910838 |
| Enumeration Date | 2012-01-14 |
| Last Update Date | 2012-01-14 |
| Authorized Official Name | MRS. DEBRA ANN KRAJEWSKI (OWNER) |
| Authorized Official Telephone | 6163181961 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385H00000X | Respite Care | AM410285883 | MI | Respite Care Facility |
| Street Address |
3554 76TH ST SE |
| City | CALEDONIA |
| State | MI |
| Zip Code | 49316-9113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366982159 | 76th St Afc LLC | Custodial Care Facility | 3554 76th St Se, Caledonia, MI 49316-9113 | 2017-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407326036 | Daina Elizabeth Graves | Occupational Therapist | 10560 Whispering Waters Ln Se, Caledonia, MI 49316 | 2018-11-27 |
| 1033619135 | Spectrum Health Primary Care Partners | Physical Therapist | 6201 68th St Se, Caledonia, MI 49316 | 2018-02-15 |
| 1538672035 | Justin Michael Keely | Student in an Organized Health Care Education/Training Program | 8441 Sunnyview Rd., Caledonia, MI 49316 | 2017-11-07 |
| 1457614521 | Rahaf Halimeh | Dentist | 3625 Riverbed Lane Se, #3, Caledonia, MI 49316 | 2012-06-22 |
| 1487913158 | Adam Zachary Mitchell | Family Medicine | 9090 S Rodgers Ct Se Ste A, Caledonia, MI 49316 | 2012-05-15 |
| 1841588522 | Oday Ali Kasim | Pharmacist | 9375 Cherry Valley Ave., Caledonia, MI 49316 | 2011-07-15 |
| 1417183344 | Allison Leigh Ford | Physical Therapist | 10047 Cross Road Ct. Se, Suite 150, Caledonia, MI 49316 | 2009-06-05 |
| 1336351741 | Paula Delorm | Physical Therapist | 6595 Gracepoint Dr. Se, Caledonia, MI 49316 | 2007-05-06 |
| 1366532798 | Wayne D Westbrook | Dentist | 3125 68th St Se, Dutton, MI 49316 | 2006-10-14 |
| 1629184056 | Patricia Brunck Cassell | Social Worker | 9090 Sourth Rodgers Court Se, Caledonia, MI 49316 | 2006-08-21 |
| Find all providers in zip 49316 | ||||
| Taxonomy Code | 385H00000X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Definition to come. |
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| 1992209142 | Thomas Hart | Respite Care | 2786 Cecelia St, Saginaw, MI 48602-5742 | 2018-03-22 |
| 1467962167 | St. Joseph Community Co-operative, Inc. | Respite Care | 811 Broadus St, Sturgis, MI 49091-2401 | 2017-10-07 |
| 1972029353 | Cherub Enterprises | Respite Care | 120 S. Main Street, Plainwell, MI 49080 | 2017-08-17 |
| 1902330632 | Diamonds of My Heart | Respite Care | 11884 E 10 Mile Rd, Warren, MI 48089-3901 | 2017-04-19 |
| 1528592664 | Advanta Medical Staffing & Consulting Services LLC | Respite Care | 61061 Preakness Blvd, South Lyon, MI 48178-8215 | 2017-04-15 |
| 1003340266 | Senior's Choice Adult Day Program | Respite Care | 17401 Mack Ave, Detroit, MI 48224-1437 | 2017-04-14 |
| 1326579269 | Just Us Club | Respite Care | 1735 S Wagner Rd, Ann Arbor, MI 48103-9715 | 2017-03-22 |
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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.