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JERRY'S DREAM ADULT HOMES
NPI 1689102931
Custodial Care Facility - Adult Care Home in Grand Rapids, MI

Active since May 31, 2017
1124 W LEONARD CT NW, GRAND RAPIDS, MI 49534(616) 735-4681 Get Directions Write a Review

NPPES record last updated: May 31, 2017. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Jerry's Dream Adult Homes NPPES

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

JERRY'S DREAM ADULT HOMES (NPI 1689102931) is a healthcare organization registered as an adult care home in Grand Rapids, Michigan and active in the NPI registry since May 2017. The organization lists Vickie Runyon, Owner, as its authorized official.

NPPES Registry Identity

NPI1689102931
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameJERRY'S DREAM ADULT HOMES
Location Address1124 W LEONARD CT NWGrand Rapids, MI 49534-6835
Mailing AddressPo Box 1086Grand Rapids, MI 49501-1086 · (616) 293-7198
Phone(616) 735-4681
Organization SubpartNo
Authorized OfficialVickie RunyonOwner · (616) 293-7198
Enumeration DateMay 31, 2017
✔ NPI 1689102931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Licenses✔ Licensed in MI · AS410269764✔ Licensed in MI · AS410269763
Definition
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.
1124 W LEONARD CT NW, Grand Rapids, MI 49534
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Other Identifiers 2

Medicaid1174395MI
Medicaid9493156MI

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 Jerry's Dream Adult Homes's NPI number?

The NPI number for Jerry's Dream Adult Homes is 1689102931. It was assigned to this organization in the NPPES registry on May 31, 2017.

Where is Jerry's Dream Adult Homes located?

Jerry's Dream Adult Homes is located at 1124 W Leonard Ct NW, Grand Rapids, MI 49534. The listed phone number is (616) 735-4681.

What is Jerry's Dream Adult Homes's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Jerry's Dream Adult Homes was last updated on May 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.