CLEARWATER HOME HEALTH SERVICES LLC (NPI# 1457553141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457553141 |
| Entity Type | Organization |
| Organization Name | CLEARWATER HOME HEALTH SERVICES LLC |
| Practice Address |
4765 Juniper Dr Kewadin MI 49648-9162 |
| Practice Telephone | 2316365901 |
| Mailing Telephone | 2316365901 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2011-08-15 |
| Authorized Official Name | MS. CHRISTINE GAYE BUTLER (OWNER) |
| Authorized Official Telephone | 2318666365901 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1093814 | 05 |
| Street Address |
4765 JUNIPER DR |
| City | KEWADIN |
| State | MI |
| Zip Code | 49648-9162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538354618 | Diantha Jeanne Soares | Licensed Practical Nurse | 4703 Us North 31, Kewadin, MI 49648 | 2007-09-11 |
| 1679938849 | Marina Friend | Massage Therapist | 2065 Royal Vw, Kewadin, MI 49648-8956 | 2015-12-15 |
| 1093136103 | Gentle Hands Home Services, LLC | In Home Supportive Care | 5474 Cairn Hwy, Kewadin, MI 49648-9135 | 2013-12-17 |
| 1538701701 | Erin Lee Beebe | Behavior Technician | 241 N Golden Beach Dr, Kewadin, MI 49648-9217 | 2019-10-09 |
| 1598871519 | Rebecca May Norris | Internal Medicine | 4016 Us Highway 31 N, Kewadin, MI 49648-9286 | 2006-08-22 |
| 1316581523 | Dawn Marie Sutherlin | Massage Therapist | 6908 Birchwood Dr, Kewadin, MI 49648-9333 | 2019-10-30 |
| 1609201524 | Balanced Home Therapy Solutions, LLC | Occupational Therapist | 4750 Ridge Ln, Kewadin, MI 49648-9338 | 2013-09-10 |
| 1699733709 | Christine Berg | Nurse Practitioner | 955 Us Highway 31 S, Kewadin, MI 49648-9371 | 2006-05-01 |
| 1336617091 | Lisa Christie Keely | Social Worker | 309 Cherokee Trl, Kewadin, MI 49648-9416 | 2018-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316581523 | Dawn Marie Sutherlin | Massage Therapist | 6908 Birchwood Dr, Kewadin, MI 49648-9333 | 2019-10-30 |
| 1538701701 | Erin Lee Beebe | Behavior Technician | 241 N Golden Beach Dr, Kewadin, MI 49648-9217 | 2019-10-09 |
| 1336617091 | Lisa Christie Keely | Social Worker | 309 Cherokee Trl, Kewadin, MI 49648-9416 | 2018-11-10 |
| 1679938849 | Marina Friend | Massage Therapist | 2065 Royal Vw, Kewadin, MI 49648-8956 | 2015-12-15 |
| 1093136103 | Gentle Hands Home Services, LLC | In Home Supportive Care | 5474 Cairn Hwy, Kewadin, MI 49648-9135 | 2013-12-17 |
| 1609201524 | Balanced Home Therapy Solutions, LLC | Occupational Therapist | 4750 Ridge Ln, Kewadin, MI 49648-9338 | 2013-09-10 |
| 1538354618 | Diantha Jeanne Soares | Licensed Practical Nurse | 4703 Us North 31, Kewadin, MI 49648 | 2007-09-11 |
| 1598871519 | Rebecca May Norris | Internal Medicine | 4016 Us Highway 31 N, Kewadin, MI 49648-9286 | 2006-08-22 |
| 1699733709 | Christine Berg | Nurse Practitioner | 955 Us Highway 31 S, Kewadin, MI 49648-9371 | 2006-05-01 |
| 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] |
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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.