MEDICARE: ZION HEALING CENTER OF GRAND RAPIDS 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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1467282343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZION HEALING CENTER OF GRAND RAPIDS LLC

Provider Business Mailing Address
First Line	:	3501 LAKE EASTBROOK BLVD SE STE 150
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-5940
Country	:	US
Telephone Number	:	616-460-1168
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 LAKE EASTBROOK BLVD SE STE 150
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-5940
Country	:	US
Telephone Number	:	616-460-1168
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES MUELLER
Credential	:
Telephone Number	:	616-460-1168

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	12/25/2025

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