EAST GRAND NURSING HOME, INC. (NPI# 1184602088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184602088 |
| Entity Type | Organization |
| Organization Name | EAST GRAND NURSING HOME, INC. |
| Practice Address |
130 E Grand Blvd Detroit MI 48207-3799 |
| Practice Telephone | 3138248224 |
| Practice Fax Number | 3138248220 |
| Mailing Telephone | 3138248224 |
| Mailing Fax Number | 3138248220 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN L BARTON (SECRETARY/TREASURER) |
| Authorized Official Telephone | 3138248224 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 834330 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PROVIDER/SUPPLIER/CLIA ID | 23E075 | 01 |
| MI | MDCIS/BHS LICENSE NUMBER | 834330 | 01 |
| MI | 60 | 05 | |
| MI | 2155219 | 05 |
| Street Address |
130 E GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-3799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679993489 | Partners In Parenting | Nursing Facility/Intermediate Care Facility | 8235 Freda St, Detroit, MI 48204-3127 | 2014-04-18 |
| 1679704886 | Eminence Home Health | Nursing Facility/Intermediate Care Facility | 20061 Bentler St, Detroit, MI 48219-1325 | 2009-08-05 |
| 1568429835 | Law-den Nursing Home, Inc. | Nursing Facility/Intermediate Care Facility | 1640 Webb St, Detroit, MI 48206-1350 | 2006-04-28 |
| 1780802116 | Neightborhood Service Organization | Nursing Facility/Intermediate Care Facility | 220 Bagley St, Detroit, MI 48226-1400 | 2007-04-23 |
| 1245211408 | Friendship Manor Nursing Home | Nursing Facility/Intermediate Care Facility | 3950 Beaubien St, Detroit, MI 48201-2120 | 2005-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669906475 | Arinas Senior Care LLC | Nursing Facility/Intermediate Care Facility | 6861 N Clunbury Rd, West Bloomfield, MI 48322-4316 | 2017-04-18 |
| 1063963304 | Susan Traut | Nursing Facility/Intermediate Care Facility | 1 Dunlap Cir, Oxford, MI 48371-5206 | 2016-10-21 |
| 1700258225 | Danielle Shilling | Nursing Facility/Intermediate Care Facility | 1011 E Central Rd, Quincy, MI 49082-9725 | 2015-10-23 |
| 1952798076 | Rehabilitation Masters PC | Nursing Facility/Intermediate Care Facility | 20331 Mauer St, Saint Clair Shores, MI 48080-1773 | 2015-04-16 |
| 1588055701 | Nextstep Billing and Payroll | Nursing Facility/Intermediate Care Facility | 3201 University Dr, Suite 250, Auburn Hills, MI 48326-2394 | 2015-02-10 |
| 1528491438 | Altum Care Homes | Nursing Facility/Intermediate Care Facility | 23408 Plum Hollow St, Southfield, MI 48033-3275 | 2013-08-14 |
| 1801233465 | Wellness Group Home Care LLC | Nursing Facility/Intermediate Care Facility | 26300 Ford Rd Ste 421, Dearborn Heights, MI 48127-2854 | 2013-05-22 |
| 1548537103 | Rest Haven Homes Inc | Nursing Facility/Intermediate Care Facility | 1424 Union Ave Ne, Grand Rapids, MI 49505-5197 | 2011-11-28 |
| 1649568726 | Aa Home Health Care, LLC | Nursing Facility/Intermediate Care Facility | 55 N Pond Dr Ste 1, Walled Lake, MI 48390-3080 | 2011-07-11 |
| 1518272970 | Michigan Visiting Care | Nursing Facility/Intermediate Care Facility | 90 Highland Dr, Jackson, MI 49201-9163 | 2010-08-10 |
| Find all providers with the same taxonomy | ||||
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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.