# MARY FREE BED REHABILITATION HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467801894
- **Authorized official:** MR. RANDALL DENEFF (CFO)
- **Authorized official phone:** (616) 840-8317

## Contact information

- **Practice address:** 235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
- **Practice address phone:** (616) 840-8000
- **Practice address fax:** (616) 840-9718
- **Mailing address:** 235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
- **Mailing address phone:** (616) 840-8000
- **Mailing address fax:** (616) 840-9718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 283XC2000X | Children's Rehabilitation Hospital | — | — | Yes |

## Other

- **Enumeration date:** 06/07/2016
- **Last updated:** 06/07/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 101556008 | — | MI |
| 01 | — | 233026 | MEDICARE ID-TYPE UNSPECIFIED | MI |
| 01 | — | 3996 | PRIORITY HEALTH | MI |