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General NPI Number Information
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NPI Number | 1285554543
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Entity Type | Organization
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Legal Business Name | MCAP GRAND RAPIDS OPCO LLC
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 1175 68TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-7895
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Country | US
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Telephone | 616-281-8054
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Fax | 616-827-1879
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Provider Business Mailing Address
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Address Line | 915 E HIGH ST STE 600
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-4820
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Country | US
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Telephone | 434-220-1055
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Fax | 434-322-3211
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | EARL PARKER
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Credential |
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Telephone | 434-220-1055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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