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I-revive Pllc
Home Health Agency in Grand Haven, Michigan
NPI 1508473000

I-revive Pllc is a Home Health Agency based in Grand Haven, MI. I-revive Pllc practices in Grand Haven, MI. The NPI Number for I-revive Pllc is 1508473000 and holds a License No. (Michigan).

The current practice location address for I-revive Pllc is 525 Elliott Ave, Grand Haven, MI and can be reached out via phone at 616-566-1603 and via fax at 616-607-8588. You can also correspond with I-revive Pllc through the mailing address at 525 ELLIOTT AVE, GRAND HAVEN, MI - 49417-1038 (mailing address contact number: 616-377-8893).

Location: 525 Elliott Ave, Grand Haven, MI, 49417-1038
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1508473000
Provider Name
I-revive Pllc
Credential
Provider Entity Type
Organization
Address
525 Elliott Ave, Grand Haven, MI, 49417-1038
Phone Number
616-566-1603
Fax Number
616-607-8588
Provider Enumeration Date
09/28/2020
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14997664 01 MI CAQH
institution
Provider Business Practice Location Address Details
Address
525 Elliott Ave
City
Grand Haven
State
Michigan
Zip
49417-1038
Phone Number
616-566-1603
Fax Number
616-607-8588
person
Provider Business Mailing Address Details
Address
525 Elliott Ave
City
Grand Haven
State
Michigan
Zip
49417-1038
Phone Number
616-566-1603
Fax Number
616-607-8588
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Preventive Medicine
Speciality
Preventive Medicine/Occupational Environmental Medicine
Taxonomy
2083P0500X
License No.
()
Definition
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
()
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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