MEDICARE: MARY FREE BED AT HOME, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1023477478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY FREE BED AT HOME, LLC

Provider Business Mailing Address
First Line	:	5440 CORPORATE DR STE 400
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48098-2645
Country	:	US
Telephone Number	:	866-402-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2944 FULLER AVE NE STE 301
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-3784
Country	:	US
Telephone Number	:	855-602-2500
Fax Number	:	855-632-4329

Authorized Official
Title or Position	:	MANAGER OF REGULATORY AFFAIRS
Name	:	KAREN L SLOAF
Credential	:
Telephone Number	:	855-602-2500

Provider Enumeration Date	:	02/14/2016
Last Update Date	:	01/07/2026

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