Provider Demographics
NPI:1699339143
Name:JUST LIKE HOME, LLC
Entity type:Organization
Organization Name:JUST LIKE HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:616-523-4310
Mailing Address - Street 1:330 4TH ST
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-9707
Mailing Address - Country:US
Mailing Address - Phone:616-523-4310
Mailing Address - Fax:616-523-4311
Practice Address - Street 1:330 4TH ST
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-9707
Practice Address - Country:US
Practice Address - Phone:616-523-4310
Practice Address - Fax:616-523-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care