Jerry'S Dream Adult Homes

LBN: Jerry'S Dream Adult Homes
Jerry'S Dream Adult Homes is an health care organization with primary practice located at 1124 W Leonard Ct Nw , Grand Rapids MI 49534-6835. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Jerry'S Dream Adult Homes can be contacted via phone (616) 735-4681, or through Runyon, Vickie via phone (616) 293-7198.

Contact Information

Primary practice address
1124 W Leonard Ct Nw Grand Rapids MI 49534-6835
Phone: (616) 735-4681
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Runyon, Vickie
Phone: (616) 293-7198

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X AS410269764 Michigan
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X AS410269763 Michigan

Profile Details

NPI number 1689102931
LBN Legal business name Jerry'S Dream Adult Homes
DBA Doing business as
Authorized official Runyon, Vickie
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2017
Last updated May 31st, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689102931 NPPES
Michigan MEDICAID 1174395
Michigan MEDICAID 9493156

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