# GRAND RAPIDS SURGICAL SUITES LLC

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

## Provider details

- **NPI number:** 1720530405
- **Authorized official:** JONATHAN BAILEY (OFFICER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (203) 609-1168

## Contact information

- **Practice address:** 2505 E PARIS AVE SE, SUITE 105, GRAND RAPIDS, MI 49546-2459
- **Practice address phone:** (616) 551-3149
- **Practice address fax:** (616) 551-3869
- **Mailing address:** 2505 E PARIS AVE SE, SUITE 105, GRAND RAPIDS, MI 49546-2459
- **Mailing address phone:** (616) 551-3149
- **Mailing address fax:** (616) 551-3869

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | MI | Yes |

## Other

- **Enumeration date:** 10/28/2016
- **Last updated:** 10/07/2024