Organization
AUDRICH, INC.
Active
Other names
Grand Rapids Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY L TEBEAU CFO (CORPORATE TREASURER)
(419) 484-1111
Entity
Organization
Contact information
Practice address
24201 3RD ST, GRAND RAPIDS, OH 43522-9785
(419) 832-5195
(419) 832-7020
Mailing address
670 FLAT ROCK RD, BELLEVUE, OH 44811-9486
(419) 484-1111
(419) 484-4048
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0274N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0966003
—
OH
01
—
4550420002
DMERC
OH
Enumeration date
07/18/2006
Last updated
08/22/2020
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