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General NPI Number Information
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NPI Number | 1285019802
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Entity Type | Organization
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Legal Business Name | MARY FREE BED SUB-ACUTE REHABILITATION
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 235 WEALTHY ST SE 5TH FLOOR
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-5247
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Country | US
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Telephone | 616-840-8330
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WEALTHY ST SE 5TH FLOOR
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-5247
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Country | US
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Telephone | 616-840-8330
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Fax |
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Authorized Official
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Title or Position | VP REIMBURSEMENT
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Name | PAMELA LATOVICK
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Credential |
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Telephone | 734-343-6628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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