Provider Demographics
NPI:1023437589
Name:SHS OF WEST MICHIGAN, LLC
Entity type:Organization
Organization Name:SHS OF WEST MICHIGAN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THRUSH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:616-234-0190
Mailing Address - Street 1:1429 WERNER AVE NW
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-2443
Mailing Address - Country:US
Mailing Address - Phone:616-234-0190
Mailing Address - Fax:866-289-0994
Practice Address - Street 1:1429 WERNER AVE NW
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49534-2443
Practice Address - Country:US
Practice Address - Phone:616-234-0190
Practice Address - Fax:866-289-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health