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TENAGNE MENGISTU
NPI 1801324538
Custodial Care Facility - Adult Care Home in Grand Rapids, MI

Active since May 25, 2017
604 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503(616) 589-4609 Get Directions Write a Review

NPPES record last updated: May 25, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tenagne Mengistu NPPES

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

TENAGNE MENGISTU (NPI 1801324538) is an individual adult care home provider in Grand Rapids, Michigan, licensed in Michigan (AF410315360) and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1801324538
Entity TypeIndividualFemale
Primary Taxonomy311ZA0620X
Provider Legal NameTENAGNE MENGISTU
Location Address604 JEFFERSON AVE SEGrand Rapids, MI 49503-5218
Mailing Address604 Jefferson Ave SeGrand Rapids, MI 49503-5218
Phone(616) 589-4609
Sole ProprietorYes
Enumeration DateMay 25, 2017
✔ NPI 1801324538 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
License✔ Licensed in MI · AF410315360
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.
604 JEFFERSON AVE SE, Grand Rapids, MI 49503
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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 Tenagne Mengistu's NPI number?

The NPI number for Tenagne Mengistu is 1801324538. It was assigned to this individual provider in the NPPES registry on May 25, 2017.

Where is Tenagne Mengistu located?

Tenagne Mengistu practices at 604 Jefferson Ave SE, Grand Rapids, MI 49503. The listed phone number is (616) 589-4609.

What is Tenagne Mengistu'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 Tenagne Mengistu was last updated on May 25, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.