Individual provider · Type 1 NPI

Tenagne Mengistu

Adult Care Home Facility · Grand Rapids, MI

NPI number 1801324538 Active

Practice location

604 Jefferson Ave SE
Grand Rapids, MI 49503-5218

Call (616) 589-4609 Map

Specialties and licenses

TaxonomyCodeLicense
Adult Care Home Facility Primary 311ZA0620XAF410315360 (MI)

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

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About NPI 1801324538

Tenagne Mengistu's National Provider Identifier is 1801324538, issued on May 25, 2017. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Grand Rapids, MI. The record was last updated on May 25, 2017.