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Provider Information for 1982189239

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MRS. ALICIA GOMEZ MS

Gender: FEMALE

Individual NPI: 1982189239

Calendar   Last Updated:  2018-10-02
  Certification Date: 

Details

Name Value
NPI 1982189239
Enumeration Date 2018-10-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 3300 36TH ST SE
GRAND RAPIDS, MI 49512-2810
United States

Phone: 616-591-4512 | Fax:
View Map External Link
Primary Practice Address 3300 36TH ST SE
GRAND RAPIDS, MI 49512-2810
United States

Phone: 616-942-2100 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 171M00000X - Case Manager/Care Coordinator