Healthcare Provider Details

I. General information

NPI: 1285554543
Provider Name (Legal Business Name): MCAP GRAND RAPIDS OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 68TH ST SE
GRAND RAPIDS MI
49508-7895
US

IV. Provider business mailing address

915 E HIGH ST STE 600
CHARLOTTESVILLE VA
22902-4820
US

V. Phone/Fax

Practice location:
  • Phone: 616-281-8054
  • Fax: 616-827-1879
Mailing address:
  • Phone: 434-220-1055
  • Fax: 434-322-3211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: EARL PARKER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 434-220-1055