HOLLAND HOME
NPI 1033287792
Skilled Nursing Facility in Grand Rapids, MI

Active since December 01, 2006CLIA 23D0651049 · Waiver
2100 RAYBROOK ST SE, SUITE 300, GRAND RAPIDS, MI 49546(616) 235-5000(616) 235-5680 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Holland Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLAND HOME (NPI 1033287792) is a healthcare organization registered as a skilled nursing facility in Grand Rapids, Michigan and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists David Tiesenga, Cfo, as its authorized official.

NPPES Registry Identity

NPI1033287792
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHOLLAND HOME
Location Address2100 RAYBROOK ST SE, SUITE 300Grand Rapids, MI 49546-5783
Mailing Address2100 Raybrook St Se, Suite 300Grand Rapids, MI 49546-5783 · (616) 235-5000 · Fax (616) 235-5680
Fax(616) 235-5680
Organization SubpartNo
Authorized OfficialDavid TiesengaCfo · (616) 235-5035
Enumeration DateDecember 1, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPI 1033287792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Also ListedAssisted Living FacilityTaxonomy 310400000X
2100 RAYBROOK ST SE, Grand Rapids, MI 49546

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0651049

Holland Home - Raybrook Manor · Grand Rapids, MI
Active · expires Aug 31, 2026
CLIA Number23D0651049
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRonald Duemler
Laboratory Phone(616) 235-5710
Laboratory LocationHolland Home - Raybrook Manor2121 Raybrook SE, Grand Rapids, MI 49546
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546
Registered Nurse (Hospice)
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546
Registered Nurse
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546
Physical Therapist
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546
Social Worker
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546
Dentist (General Practice)
2100 RAYBROOK ST SE, SUITE 106
GRAND RAPIDS, MI 49546
Registered Nurse (Psychiatric/Mental Health)
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546
Registered Nurse (Hospice)
2100 RAYBROOK ST SE
GRAND RAPIDS, MI 49546

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holland Home's NPI number?

The NPI number for Holland Home is 1033287792. It was assigned to this organization in the NPPES registry on December 1, 2006.

Where is Holland Home located?

Holland Home is located at 2100 Raybrook St SE Suite 300, Grand Rapids, MI 49546. The listed phone number is (616) 235-5000.

What is Holland Home's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Holland Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0651049) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Holland Home was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.