HAROLD AND GRACE UPJOHN COMMUNITY CARE CENTER (NPI# 1124002910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124002910 |
| Entity Type | Organization |
| Organization Name | HAROLD AND GRACE UPJOHN COMMUNITY CARE CENTER |
| Practice Address |
2400 Portage St Kalamazoo MI 49001-3728 |
| Practice Telephone | 2693814290 |
| Practice Fax Number | 2693435474 |
| Mailing Telephone | 2693814290 |
| Mailing Fax Number | 2693435474 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2012-01-18 |
| Authorized Official Name | MR. DANA WHITE (ADMINISTRATOR) |
| Authorized Official Telephone | 2693814290 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE COMMUNITY OF KALAMAZOO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 394090 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BC BS OF MI | 09557 | 01 |
| MI | 2081160 | 05 |
| Street Address |
2400 PORTAGE ST |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49001-3728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467915009 | Nicole Sobell | Speech-Language Pathologist | 2400 Portage St, Kalamazoo, MI 49001-3728 | 2019-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568004372 | Tiffany Malory | Counselor | 2030 Portage St., Kalamazoo, MI 49001 | 2019-10-14 |
| 1770050502 | Trevor F Eisaman | Chiropractor | 1324 S Park St Suite #3, Kalamazoo, MI 49001 | 2018-10-30 |
| 1104318369 | Marathon Health LLC | Nurse Practitioner | 3520 Covington Rd, Kalamazoo, MI 49001 | 2018-06-04 |
| 1407374580 | Joel Damian Burnett | Counselor | 401 Howard St., Kalamazoo, MI 49001 | 2017-09-08 |
| 1538686449 | Amber Dawn Beauchamp | Counselor | 401 S. Howard St., Kalamazoo, MI 49001 | 2017-08-23 |
| 1740645381 | Integrated Spine and Pain Center Pllc | Durable Medical Equipment & Medical Supplies | 1324 S. Park Street, Kalamazoo, MI 49001 | 2015-12-28 |
| 1366825317 | Abigail Rose Franklin- Bly | Social Worker | 1608 Lake St., Kalamazoo, MI 49001 | 2015-07-08 |
| 1194108142 | Glenn Pohl | Social Worker | 1608 Lake Street, Kalamazoo, MI 49001 | 2015-07-08 |
| 1285996850 | Aisha Coulson-walters | Social Worker | 1501 Fulford St, Kalamazoo, MI 49001 | 2012-06-11 |
| 1912279282 | Custom Carelink, L.L.C. | Home Health | 2300 Portage St., Apt. 127, Kalamazoo, MI 49001 | 2012-02-02 |
| Find all providers in zip 49001 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386656775 | Kalamazoo Care Center, Inc | Skilled Nursing Facility | 1430 Alamo Ave, Kalamazoo, MI 49006-2216 | 2006-08-13 |
| 1851331631 | Heartland of Kalamazoo Mi LLC | Skilled Nursing Facility | 3625 W Michigan Ave, Kalamazoo, MI 49006-5427 | 2006-06-08 |
| 1376590851 | Tendercare Michigan Inc. | Skilled Nursing Facility | 2575 N Drake Rd, Kalamazoo, MI 49006-1358 | 2006-05-28 |
| 1306893805 | Tendercare Kalamazoo Inc. | Skilled Nursing Facility | 1701 S Eleventh St, Kalamazoo, MI 49009-1775 | 2006-05-28 |
| 1598719510 | Fountains Bronson Place Sl, LLC | Skilled Nursing Facility | 1451 Bronson Way, Kalamazoo, MI 49009-3306 | 2006-05-22 |
| 1912963190 | Borgess Nursing Home Inc | Skilled Nursing Facility | 3057 Gull Rd, Kalamazoo, MI 49048-1281 | 2006-04-25 |
| 1649261488 | Lifecare, Inc. | Skilled Nursing Facility | 1400 N Drake Rd, Kalamazoo, MI 49006 | 2005-11-01 |
| 1821087701 | Alamo Nursing Home, Inc. | Skilled Nursing Facility | 8290 W C Ave, Kalamazoo, MI 49009-8825 | 2005-10-14 |
| 1841736725 | Kalamazoo Opco II, LLC | Skilled Nursing Facility | 3625 W Michigan Ave, Kalamazoo, MI 49006-5427 | 2017-01-16 |
| 1245618339 | Watermark Bronson Place, LLC | Skilled Nursing Facility | 1451 Bronson Way, Kalamazoo, MI 49009-3306 | 2015-05-11 |
| Find all providers in KALAMAZOO | ||||
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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.