Provider Demographics
NPI:1699598284
Name:MEALS ON WHEELS WESTERN MICHIGAN
Entity type:Organization
Organization Name:MEALS ON WHEELS WESTERN MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-403-2060
Mailing Address - Street 1:2900 WILSON AVE SW STE 500
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-1395
Mailing Address - Country:US
Mailing Address - Phone:616-459-3111
Mailing Address - Fax:616-224-0220
Practice Address - Street 1:2900 WILSON AVE SW STE 500
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-1395
Practice Address - Country:US
Practice Address - Phone:616-459-3111
Practice Address - Fax:616-224-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No174200000XOther Service ProvidersMeals
No335G00000XSuppliersMedical Foods Supplier