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Grand Haven Health

In Home Supportive Care in Jackson, TN. Organization (NPI-2).

NPI number1487531174
StatusActive
Last updated in NPPESAug 16, 2025

Details

NPI
1487531174
Entity type
Organization (NPI-2)
Legal business name
Grand Haven Health
Organization subpart
No
Enumeration date
Aug 16, 2025
Certification date
Aug 16, 2025
Last updated
Aug 16, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive Care––Yes
251B00000X Case Management––
343900000X Non-emergency Medical Transport (VAN)––
251E00000X Home Health––
251S00000X Community/Behavioral Health––

Practice location

620 Old Hickory Blvd Ste 440c
Jackson, TN 38305-2904

Phone 731-330-4769

Mailing address

620 Old Hickory Blvd Ste 440c
Jackson, TN 38305-2904

Authorized official

Krystle Burton
Agency Owner
7313304769

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