OrganizationActive
Age Management, LLC
NPI 1376482281 · Early Intervention Provider Agency · Grand Rapids, MI
Provider details
- NPI number
- 1376482281
- Entity type
- Organization
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Organization subpart
- No
- Authorized official
- Autumn Wilson, Administrator(260) 609-8792
Specialties & taxonomies
Agencies
- Community/Behavioral Health Agency251S00000X
Agencies
Practice location
4550 Plainfield Ave Ne
Grand Rapids, MI 49525-1642
Phone: (616) 381-4001
Approximate (ZIP-level) locationGet directions
Mailing address
4550 Plainfield Ave Ne
Grand Rapids, MI 49525-1642
Registry dates
- Enumerated
- 2026-03-26
- Last updated
- 2026-04-08
- Certified
- 2026-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.