INDIAN TRAILS CAMP, INC.


Address: O-1859 Lake Michigan Dr. Nw, Grand Rapids, MI 49534
Phone: 6166775251

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).

Provider Overview

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

Taxonomy

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

Other Provider IDs and Locations

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

Office Location

Street Address O-1859 LAKE MICHIGAN DR. NW
City GRAND RAPIDS
State MI
Zip Code 49534

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 385H00000X
Grouping Respite Care Facility
Classification Respite Care

Taxonomy Definition

Definition to come.

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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

Providers in the same taxonomy and state

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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
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Competitor

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City GRAND RAPIDS
Zip Code 49534

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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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