ENDEAVOR BEHAVIORAL HEALTH, LLC (NPI# 1306334115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306334115 |
| Entity Type | Organization |
| Organization Name | ENDEAVOR BEHAVIORAL HEALTH, LLC |
| Practice Address |
225 Michigan St. Nw #3520 Grand Rapids MI 49501-3520 |
| Practice Telephone | 2487980474 |
| Mailing Telephone | 2487980474 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |
| Authorized Official Name | BETH A BOOGHOLT (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2487980474 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| Y | 252Y00000X | Early Intervention Provider Agency | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INDIVIDUAL NPI | 1265760128 | 01 |
| Street Address |
225 MICHIGAN ST. NW #3520 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49501-3520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205229853 | Hope Network | Point of Service | 755 36th St. Se, Grand Rapids, MI 49501 | 2015-03-06 |
| 1356615009 | Suzanne M Portillo | Social Worker | 901 Eastern, Grand Rapids, MI 49501 | 2012-02-28 |
| 1023388964 | Jamie Lynn Palma | Case Manager/Care Coordinator | 781 36th St Grand Rapids, Mi 49501-0141, Grand Rapids, MI 49501-0141 | 2012-01-10 |
| 1831477587 | Zachary William Gray | Case Manager/Care Coordinator | 781 36th St., Grand Rapids, MI 49501-0141 | 2011-07-29 |
| 1023318557 | Dawn Marie Macdonald | Case Manager/Care Coordinator | 781 36th Street, Grand Rapids, MI 49501-0141 | 2010-11-01 |
| 1952625626 | Karen Jean Bandstra | Registered Nurse | 765 36th Street, Grand Rapids, MI 49501-0141 | 2010-03-24 |
| 1730415050 | Dawn Kay Carpenter | Social Worker | 781 - 36th St., Se, Hope Network Dcs, Grand Rapids, MI 49501-0141 | 2009-10-21 |
| 1184778409 | Annelise Erdman | Case Manager/Care Coordinator | 781 36th St Se, Grand Rapids, MI 49501-0141 | 2007-01-23 |
| 1821446535 | Sheryl Nelson | Social Worker | 300 68th St Se, Grand Rapids, MI 49501-0165 | 2016-06-03 |
| 1508048331 | Patrick Mugi Kamau | Counselor | 901 Eastern Ave. Ne, Grand Rapids, MI 49501-0294 | 2007-12-04 |
| Find all providers in zip 49501 | ||||
| Taxonomy Code | 252Y00000X |
| Grouping | Agencies |
| Classification | Early Intervention Provider Agency |
| Early intervention services are an effective way to address the needs of infants and toddlers who have developmental delays or disabilities. The services are made available through a federal law known as the Individuals with Disabilities Education Act (IDEA). IDEA provides states and territories with specific requirements for providing early intervention services to infants and toddlers with special needs. In turn, each state and territory develops its own policies for carrying out IDEA and its requirements. Broadly speaking, early intervention services are special services for eligible infants and toddlers and their families. These services are designed to identify and meet children’s needs in five developmental areas. These areas are: physical development, cognitive development, communication, social or emotional development, and adaptive development. |
| Notes: Source: National Dissemination Center for Children with Disabilities [7/1/2007: new] http://www.nichcy.org/pubs/parent/pa2txt.htm |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356654503 | New Beginnings | Early Intervention Provider Agency | 1119 Burton St Se, Grand Rapids, MI 49507-3367 | 2010-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972127256 | Jennifer Shepherd | Early Intervention Provider Agency | 36380 Garfield Rd Ste 4, Clinton Township, MI 48035-1162 | 2020-06-03 |
| 1437663689 | Experience Living, LLC | Early Intervention Provider Agency | 1829 Westridge Dr, Rochester Hills, MI 48306-3276 | 2017-11-27 |
| 1336674415 | Educating U4 Life Cdc | Early Intervention Provider Agency | 19321 W Chicago St, Detroit, MI 48228-1739 | 2017-04-26 |
| 1649711979 | Baby & Mom Wellness LLC | Early Intervention Provider Agency | 6689 Orchard Lake Rd Ste 233, W Bloomfield, MI 48322-3404 | 2017-03-20 |
| 1750828141 | Elizabeth Upjohn Community Healing Center | Early Intervention Provider Agency | 1603 Redstock Ave, Portage, MI 49024-4143 | 2017-01-24 |
| 1407392301 | Great Start LLC | Early Intervention Provider Agency | 21206 Clear Creek Blvd, Clinton Twp, MI 48036-1466 | 2017-01-16 |
| 1982149894 | Modern Day Midwifery LLC | Early Intervention Provider Agency | 15596 Thomas Ave, Allen Park, MI 48101-1948 | 2017-01-01 |
| 1073063541 | Cradle Connections LLC | Early Intervention Provider Agency | 18101 I Dr N, Marshall, MI 49068-9462 | 2016-10-09 |
| 1568916930 | Kelly Ann Stetser | Early Intervention Provider Agency | 725 E Main Ave, Zeeland, MI 49464-1331 | 2016-08-15 |
| 1083065767 | Diversified Educational Consulting Services | Early Intervention Provider Agency | 38086 Lantern Hill Ct, Farmington Hills, MI 48331-2896 | 2016-06-24 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49501 |
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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.