HOLLAND HOME - FULTON MANOR
NPI 1972557460
Skilled Nursing Facility in Grand Rapids, MI

Active since May 20, 2006
1450 EAST FULTON, GRAND RAPIDS, MI 49503(616) 643-2600(616) 643-2623 Get Directions Write a Review

NPPES record last updated: March 10, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Holland Home - Fulton Manor NPPES

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

HOLLAND HOME - FULTON MANOR (NPI 1972557460) is a healthcare organization registered as a skilled nursing facility in Grand Rapids, Michigan and active in the NPI registry since May 2006. The organization lists David Tiesenga, Cfo, as its authorized official.

NPPES Registry Identity

NPI1972557460
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHOLLAND HOME
Location Address1450 EAST FULTONGrand Rapids, MI 49503-3854
Mailing Address1450 East FultonGrand Rapids, MI 49503-3854 · (616) 643-2600 · Fax (616) 643-2623
Fax(616) 643-2623
Organization SubpartYes
Authorized OfficialDavid TiesengaCfo · (616) 235-5035
Enumeration DateMay 20, 2006
Last NPPES UpdateMarch 10, 2016
NPI 1972557460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MI · 14196
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.
1450 EAST FULTON, Grand Rapids, MI 49503

Other Names 1

Other NameHolland Home - Fulton Manor

Other Identifiers 3

Medicaid2081311MI
Medicare OSCAR/certification235435
Other09887Bcbs Of Michigan

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 1972557460. It was assigned to this organization in the NPPES registry on May 20, 2006. The provider is also known as Holland Home - Fulton Manor.

Where is Holland Home located?

Holland Home is located at 1450 East Fulton, Grand Rapids, MI 49503. The listed phone number is (616) 643-2600.

What is Holland Home's specialty?

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

When was this NPI record last updated?

The NPPES record for Holland Home was last updated on March 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.