INDIAN TRAILS CAMP, INC. (NPI# 1972847184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972847184 |
Entity Type | Organization |
Organization Name | INDIAN TRAILS CAMP, INC. |
Practice Address |
O-1859 Lake Michigan Dr. Nw Grand Rapids MI 49534 |
Mailing Address |
Po Box 97 Grandville MI 49468 |
Practice Telephone | 6166775251 |
Practice Fax Number | 6166772955 |
Mailing Telephone | 6166775251 |
Mailing Fax Number | 6166772955 |
Enumeration Date | 2012-11-15 |
Last Update Date | 2012-11-15 |
Authorized Official Name | MR. TIMOTHY HILEMAN (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 6166775251 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
N | 385H00000X | Respite Care | AC700200613 | MI | Respite Care Facility |
Y | 385H00000X | Respite Care | SR700200220 | MI | Respite Care Facility |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629381868 | Indian Trails Camp, Inc. | Respite Care | O-1859 Lake Michigan Dr Nw, Grand Rapids, MI 49534-9578 | 2010-07-16 |
Street Address |
O-1859 LAKE MICHIGAN DR. NW |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49534 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336792324 | Heather Duthler | Social Worker | 648 Kinney Ave Nw, Grand Rapids, MI 49534 | 2019-07-19 |
1114473550 | Tari Kruzel | Registered Nurse | 12955 3rd Ave Nw, Grand Rapids, MI 49534 | 2016-08-26 |
1871743815 | Michael Robert Anderson Jr. | Chiropractor | 0-705 Tallmadge Woods Dr. Nw, Suite A, Grand Rapids, MI 49534 | 2008-09-26 |
1750459285 | Rick David Saier | Internal Medicine | 1175 Wilson Ave, Walker, MI 49534 | 2006-12-01 |
1154414886 | Edward D Young Dds PC | Dentist | 4310 Leonard Nw, Grand Rapids, MI 49534 | 2006-10-02 |
1558461756 | Sandra Staublin | Pediatrics | 4288 3 Mile Road, Walker, MI 49534 | 2006-09-25 |
1700986999 | Belinda Chou | Pediatrics | 4288 Three Mile Road, Walker, MI 49534 | 2006-09-25 |
1639196603 | David Robert Felton | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534 | 2006-07-16 |
1952349235 | Chiropractic Plus, P.C. | Chiropractor | 0 699 Tallmadge Wds Nw, Suite B, Grand Rapids, MI 49534 | 2006-06-02 |
1326351156 | Quratul A Aziz | Internal Medicine | 1175 Wilson Ave Nw, Walker, MI 49534 | 2010-07-21 |
Find all providers in zip 49534 |
Taxonomy Code | 385H00000X |
Grouping | Respite Care Facility |
Classification | Respite Care |
Definition to come. |
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---|---|---|---|---|
1053850776 | Fannview Afc LLC | Respite Care | 1948 Millbank St Se, Grand Rapids, MI 49508-2673 | 2017-02-14 |
1215358692 | Mary Schroeder | Respite Care | 34005 Wolf Pack Path, Grand Rapids, MN 55744-6562 | 2014-01-02 |
1518571272 | Nicholas Morris | Respite Care | 1115 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2020-09-01 |
1649810441 | Hannah Elizabeth Crouch | Respite Care | 1101 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2020-01-09 |
1235594920 | Cherry Health | Respite Care | 101 Sheldon Blvd Se, Grand Rapids, MI 49503-4262 | 2015-12-22 |
1376974808 | Jacob Smith | Respite Care | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2013-12-10 |
1528356789 | Hope Network | Respite Care | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2011-07-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649810755 | Our Syncere Hearts LLC | Respite Care | 5836 N Marsh Bank Ln Apt 203, Clarkston, MI 48346-3098 | 2020-01-07 |
1184180903 | Just Like Home Quality Care | Respite Care | 1602 Waldman Ave, Flint, MI 48507-1509 | 2019-02-17 |
1568927317 | Trustcare Group Home, Inc. | Respite Care | 15565 Northland Dr W Ste 604, Southfield, MI 48075-5319 | 2019-02-06 |
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 |
Find all providers with the same taxonomy |
City | GRAND RAPIDS |
Zip Code | 49534 |
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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.