GREAT LAKES SPECIALTY HOSPITAL - OAK LLC (NPI# 1609800614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609800614 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES SPECIALTY HOSPITAL - OAK LLC |
| Other Organization Name | SELECT SPECIALTY HOSPITAL - GRAND RAPIDS |
| Practice Address |
200 Jefferson Ave Se 5th Floor Grand Rapids MI 49503-4502 |
| Mailing Address |
4714 Gettysburg Rd Legal Dept Mechanicsburg PA 17055-4325 |
| Practice Telephone | 2317776202 |
| Practice Fax Number | 2317776207 |
| Mailing Telephone | 7179721100 |
| Mailing Fax Number | 7179759981 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-09-28 |
| Authorized Official Name | MR. MICHAEL TARVIN (VICE PRESIDENT) |
| Authorized Official Telephone | 7179721100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | 610052 | MI | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4132090 | 05 |
| Other Name | Type Code |
|---|---|
| Select Specialty Hospital - Grand Rapids | Doing Business As Name - Organization |
| Street Address |
200 JEFFERSON AVE SE 5TH FLOOR |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929353 | Grand River Emergency Medical Group Plc | Emergency Medicine | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2005-06-01 |
| 1073130449 | Jessica Goldsworthy | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-07-01 |
| 1851918551 | Lacy J Worden | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-29 |
| 1669099560 | Kamah Ellena | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-26 |
| 1629694344 | Yoad Yechiel Porat | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1851917587 | Danuka Manupriya Ubayasena | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1619593530 | Albert Dongzhou Jiao | Radiology | 200 Jefferson Ave Se, Jefferson Suite 360, Grand Rapids, MI 49503 | 2020-06-17 |
| 1548882046 | Rebecca Tourison | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-05-07 |
| 1942821079 | Breanne Nicole Ranucci | Physician Assistant | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-29 |
| 1750901757 | Nicholas Patrick Callahan | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972032209 | Special Care Hospital, LLC | Long Term Care Hospital | 1840 Wealthy St Se Fl 5, Grand Rapids, MI 49506-2921 | 2017-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508027624 | Vibra of Southeastern Michigan LLC | Long Term Care Hospital | 26400 West Outer Dr, Lincoln Park, MI 48146-2088 | 2008-06-20 |
| 1962512863 | Mclaren Bay Special Care | Long Term Care Hospital | 3250 E Midland Rd Ste 1, Bay City, MI 48706-2835 | 2006-08-30 |
| 1801872379 | Scci Hospitals of America Inc. | Long Term Care Hospital | 4777 East Outer Drive, Detroit, MI 48234-3241 | 2005-12-16 |
| 1245230671 | Great Lakes Specialty Hosptial - Hackley LLC | Long Term Care Hospital | 1700 Clinton St, 2 South, 2nd and 3rd Floors, Muskegon, MI 49442-5502 | 2005-07-28 |
| 1205836806 | Select Specialty Hospital - Northwest Detroit Inc | Long Term Care Hospital | 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 | 2005-07-26 |
| 1912907635 | Select Specialty Hospital - Macomb County Inc | Long Term Care Hospital | 215 North Ave, Mount Clemens, MI 48043-1716 | 2005-07-22 |
| 1912906934 | Select Specialty Hospital - Flint Inc | Long Term Care Hospital | 401 S Ballenger Hwy, Flint, MI 48532-3638 | 2005-07-20 |
| 1225034895 | Select Specialty Hospital - Battle Creek Inc | Long Term Care Hospital | 300 North Ave, Fl 6, Battle Creek, MI 49017-3307 | 2005-06-28 |
| 1427564855 | Select Specialty Hospital - Macomb County Inc | Long Term Care Hospital | 22101 Moross Rd, Detroit, MI 48236-2148 | 2017-12-21 |
| 1538426655 | Henry Ford Health System | Long Term Care Hospital | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48101-2608 | 2012-04-13 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on GREAT LAKES SPECIALTY HOSPITAL - OAK LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.