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Organization
GREAT LAKES SPECIALTY HOSPITAL - OAK LLC
Active
Organization
GREAT LAKES SPECIALTY HOSPITAL - OAK LLC
Active
Other names
Select Specialty Hospital - Grand Rapids
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
200 JEFFERSON AVE SE, 5TH FLOOR, GRAND RAPIDS, MI 49503-4502
(231) 777-6202
(231) 777-6207
Mailing address
4714 GETTYSBURG RD, LEGAL DEPT, MECHANICSBURG, PA 17055-4325
(717) 972-1100
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
610052
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4132090
—
MI
Enumeration date
07/10/2006
Last updated
09/28/2015
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