Provider Demographics
NPI:1710989298
Name:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Entity Type:Organization
Organization Name:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Other - Org Name:GRAND RAPIDS HOME FOR VETERANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF BUSINESS SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-275-1183
Mailing Address - Street 1:3000 MONROE AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-3397
Mailing Address - Country:US
Mailing Address - Phone:616-364-5295
Mailing Address - Fax:616-365-3822
Practice Address - Street 1:3000 MONROE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-3397
Practice Address - Country:US
Practice Address - Phone:616-364-5295
Practice Address - Fax:616-365-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700D16190OtherBCBS OF MICHIGAN
MI700D16190OtherBCBS OF MICHIGAN
MI0N41790Medicare ID - Type UnspecifiedDIETITIAN GROUP
MI0D16193Medicare ID - Type UnspecifiedSOCIAL WORK GROUP