Provider Demographics
NPI:1851274344
Name:KELSEA'S SACRED DWELLINGS
Entity type:Organization
Organization Name:KELSEA'S SACRED DWELLINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TENAE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-822-8549
Mailing Address - Street 1:PO BOX 602
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49468-0602
Mailing Address - Country:US
Mailing Address - Phone:616-822-8549
Mailing Address - Fax:
Practice Address - Street 1:5127 WINDCREST AVE SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49418-9729
Practice Address - Country:US
Practice Address - Phone:616-822-8549
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