EASTERN GROUPHOME (NPI# 1639687213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639687213 |
| Entity Type | Organization |
| Organization Name | EASTERN GROUPHOME |
| Practice Address |
5770 Eastern Ave Se Grand Rapids MI 49508-6281 |
| Practice Telephone | 6165163888 |
| Mailing Telephone | 6165163888 |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |
| Authorized Official Name | AMANUEL ASFAHA (OWENER) |
| Authorized Official Telephone | 6165163888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Street Address |
5770 EASTERN AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49508-6281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
| 1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
| 1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
| 1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
| Find all providers in zip 49508 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992339311 | Kelly R Niezurawski | PACE Provider Organization | 6500 N Hawkins Hwy, Manitou Beach, MI 49253-9736 | 2020-02-25 |
| 1881253540 | Sears Transportaion, LLC | PACE Provider Organization | 17800 Northland Park Ct Ste 104b2, Southfield, MI 48075-4304 | 2019-06-06 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1528549300 | Sonja Hunter | PACE Provider Organization | 14459 Greenview Rd, Detroit, MI 48223-2913 | 2018-08-28 |
| 1578845095 | Comforter Care Agency | PACE Provider Organization | 4830 Malpaso, Lansing, MI 48917-1554 | 2011-09-10 |
| 1427282136 | Jcb Adult Day Services | PACE Provider Organization | 21500 Greenfield Rd, Suite 201, Oak Park, MI 48237-3009 | 2009-05-08 |
| 1598964926 | Finner-williams & Associates | PACE Provider Organization | 17620 W Mcnichols Rd, Detroit, MI 48235-3327 | 2007-07-16 |
| 1043422660 | Progressive Lifestyles, Inc. | PACE Provider Organization | 2669 Potter Rd, Wixom, MI 48393-1832 | 2007-05-04 |
| 1639244734 | Clean House, Inc. | PACE Provider Organization | 24750 Swanson Rd, Southfield, MI 48034-5320 | 2006-11-22 |
| 1952918237 | Pace Central Michigan | PACE Provider Organization | 1750 E Bellows St, Mt Pleasant, MI 48858-3872 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49508 |
Please comment or provide details below to improve the information on EASTERN GROUPHOME.
| 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.