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Organization
MARY FREE BED REHABILITATION HOSPITAL
Active
Organization
MARY FREE BED REHABILITATION HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL DENEFF (CFO)
(616) 840-8317
Entity
Organization
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8000
(616) 840-9718
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8000
(616) 840-9718
Taxonomy
Speciality
Code
Description
License number
State
283XC2000X
Children's Rehabilitation Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101556008
—
MI
01
—
233026
MEDICARE ID-TYPE UNSPECIFIED
MI
01
—
3996
PRIORITY HEALTH
MI
Enumeration date
06/07/2016
Last updated
06/07/2016
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