Organization
MARY FREE BED REHABILITATION HOSPTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL L DENEFF (CFO)
(616) 242-0403
Entity
Organization
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 242-0300
(616) 242-0438
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 242-0300
(616) 242-0438
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
L1386838
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3996
PRIORITY HEALTH RADIOLOGY
—
Enumeration date
11/23/2009
Last updated
11/23/2009
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