CYCLE OF LIFE SUPPORT COMMUNITY HEALTH SERVICES LLC (NPI# 1023645884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023645884 |
| Entity Type | Organization |
| Organization Name | CYCLE OF LIFE SUPPORT COMMUNITY HEALTH SERVICES LLC |
| Other Organization Name | CYCLE OF LIFE SUPPORT CHS |
| Practice Address |
1520 E Ganson St Jackson MI 49202-3530 |
| Mailing Address |
717 Prince St Se Grand Rapids MI 49507-1241 |
| Practice Telephone | 6162758930 |
| Practice Fax Number | 6166083693 |
| Mailing Telephone | 7204413141 |
| Mailing Fax Number | 6166083693 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | THERESA WILLIAMS (OPERATIONS MANAGER) |
| Authorized Official Telephone | 7204413141 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251F00000X | Home Infusion | Agencies | ||
| N | 251G00000X | Hospice Care, Community Based | Agencies | ||
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| Y | 251E00000X | Home Health | Agencies |
| Other Name | Type Code |
|---|---|
| Cycle of Life Support CHS | Doing Business As Name - Organization |
| Street Address |
1520 E GANSON ST |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-3530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029930 | Just Like Family Home Care LLC | Home Health | 910 E Northside Dr # 910e, Jackson, MS 39206-5533 | 2020-10-05 |
| 1235743162 | Shymeka Bolden | Home Health | 405 Dewitt Ave, Jackson, MS 39203 | 2020-09-08 |
| 1023647955 | Jennifer Mcneil | Home Health | 5814 Clinton Blvd # 2b, Jackson, MS 39209-2807 | 2020-04-02 |
| 1326670977 | Tyesha Smith | Home Health | 200 Rebel Woods Dr, Jackson, MS 39212-3009 | 2020-02-11 |
| 1780230185 | Avis Caring Hands Home Service | Home Health | 1419 Cooks Ave, Jackson, MS 39212-4376 | 2019-08-13 |
| 1063073500 | Dorothy Jean Homes | Home Health | 1836 First Ave, Jackson, MS 39209-6345 | 2019-06-25 |
| 1750941027 | Rock Care Home Health, LLC | Home Health | 3130 E Jackson Blvd Ste B, Jackson, MO 63755-2957 | 2019-06-18 |
| 1417415548 | Serenity Home Health Care | Home Health | 283 Parks Rd, Jackson, MS 39212-9604 | 2019-03-07 |
| 1841762192 | All About You Care LLC | Home Health | 716 Tomlinson St, Jackson, MI 49203-2060 | 2018-12-27 |
| 1013489483 | Sarah Gillum | Home Health | 1127 Greenbriar St, Jackson, MS 39211-2735 | 2018-12-26 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.