Provider Demographics
NPI:1225861750
Name:FIDELIS COMMUNITY SERVICES LTD
Entity type:Organization
Organization Name:FIDELIS COMMUNITY SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIUD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-203-9430
Mailing Address - Street 1:1971 E BELTLINE AVE NE # 106-1868
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-7045
Mailing Address - Country:US
Mailing Address - Phone:774-203-9430
Mailing Address - Fax:
Practice Address - Street 1:9580 56TH AVE APT A
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-7303
Practice Address - Country:US
Practice Address - Phone:774-203-9430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility