Provider Demographics
NPI:1043070758
Name:COMMUNITY CAREGIVERS
Entity type:Organization
Organization Name:COMMUNITY CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YEVETTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-328-4993
Mailing Address - Street 1:935 MERRIFIELD ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3337
Mailing Address - Country:US
Mailing Address - Phone:616-328-4993
Mailing Address - Fax:
Practice Address - Street 1:935 MERRIFIELD ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-3337
Practice Address - Country:US
Practice Address - Phone:616-328-4993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDS & FAMILY HOME CARE AGENCY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health