Provider Demographics
NPI:1619197407
Name:GRAND RAPIDS HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:GRAND RAPIDS HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDWAKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:313-595-0737
Mailing Address - Street 1:3033 ORCHARD VISTA DR SE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7077
Mailing Address - Country:US
Mailing Address - Phone:616-957-9914
Mailing Address - Fax:616-957-9900
Practice Address - Street 1:3033 ORCHARD VISTA DR SE
Practice Address - Street 2:SUITE 311
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7077
Practice Address - Country:US
Practice Address - Phone:616-957-9914
Practice Address - Fax:616-957-9900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health