Provider Demographics
NPI:1396628848
Name:STREAMS OF GRACE LLC
Entity type:Organization
Organization Name:STREAMS OF GRACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-835-2609
Mailing Address - Street 1:9104 PECK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-9030
Mailing Address - Country:US
Mailing Address - Phone:616-835-2609
Mailing Address - Fax:
Practice Address - Street 1:9104 PECK LAKE RD
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-9030
Practice Address - Country:US
Practice Address - Phone:616-835-2609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care