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GREAT LAKES SPECIALTY HOSPITAL - OAK LLC NPI 1609800614


NPI Information

NPI: 1609800614
Provider Name: GREAT LAKES SPECIALTY HOSPITAL - OAK LLC

Doing Business As: SELECT SPECIALTY HOSPITAL - GRAND RAPIDS

Classification: Long Term Care Hospital - 282E00000X
Entity Type: Organization
Address:
200 JEFFERSON AVE SE
5TH FLOOR
GRAND RAPIDS, MI
ZIP 49503
Phone: (231) 777-6202
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GREAT LAKES SPECIALTY HOSPITAL - OAK LLC is a long term care hospital in Grand Rapids, MI. The provider is long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. GREAT LAKES SPECIALTY HOSPITAL - OAK LLC NPI is 1609800614. The provider is registered as an organization entity type.
The provider Is Doing Business As Select Specialty Hospital - Grand Rapids.

The provider's business location address is:

200 JEFFERSON AVE SE
5TH FLOOR
GRAND RAPIDS, MI
ZIP 49503-502
Phone: (231) 777-6202
Fax: (231) 777-6207

The provider's authorized official is Michael Tarvin .
The authorized official title is Vice President and has the following contact phone number (717) 972-1100.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 9/28/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1282E00000XLong Term Care Hospital610052MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14132090MEDICAIDMICHIGAN
2232026MEDICARE OSCAR/CERTIFICATIONMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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