Provider Demographics
NPI:1386248052
Name:COMMUNITY HOME HEALTH CARE OF WEST MICHIGAN, INC
Entity type:Organization
Organization Name:COMMUNITY HOME HEALTH CARE OF WEST MICHIGAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEESTMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-821-3485
Mailing Address - Street 1:1519 E RIVER RD STE A
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-8591
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1519 E RIVER RD STE A
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-8591
Practice Address - Country:US
Practice Address - Phone:231-733-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty