Holland Home - Fulton Manor

LBN: Holland Home
Holland Home - Fulton Manor is an health care organization with primary practice located at 1450 East Fulton , Grand Rapids MI 49503-3854. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Holland Home can be contacted via phone (616) 643-2600, or through Tiesenga, David via phone (616) 235-5035.

Contact Information

Primary practice address
1450 East Fulton Grand Rapids MI 49503-3854
Phone: (616) 643-2600
Fax: (616) 643-2623
Website:
Map and Directions
Authorized official contact:
Name: Tiesenga, David
Phone: (616) 235-5035

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 14196 Michigan

Profile Details

NPI number 1972557460
LBN Legal business name Holland Home
DBA Doing business as Holland Home - Fulton Manor
Authorized official Tiesenga, David
Entity Organization
Organization subpart 1 Yes
Enumeration date May 20th, 2006
Last updated Mar 10th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1972557460 NPPES
Michigan MEDICAID 2081311
Michigan Other 09887

Popular Providers