# GRAND RAPIDS OPCO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medilodge of Grand Rapids
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083347660
- **Authorized official:** MR. CRAIG A FLASHNER (LLC MEMBER)
- **Authorized official phone:** (805) 819-3351

## Contact information

- **Practice address:** 2000 LEONARD ST NE, GRAND RAPIDS, MI 49505-5837
- **Practice address phone:** (616) 458-1133
- **Practice address fax:** (616) 458-0743
- **Mailing address:** 7400 NEW LA GRANGE RD STE 400, LOUISVILLE, KY 40222-4870
- **Mailing address phone:** (502) 429-8069
- **Mailing address fax:** (866) 360-1098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2022
- **Last updated:** 06/21/2024