NPIMap

Organization Active NPI

Spectrum Health Worth Services

Doing business as Spectrum Health Neuro Rehab Services-Residential

  • Physical Disabilities Residential Treatment Facility
  • Grand Rapids, MI
National Provider Identifier
1164734364
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Legal business name
SPECTRUM HEALTH WORTH SERVICES
Doing business as
Spectrum Health Neuro Rehab Services-Residential
Practice address
4130 Kalamazoo Ave SE
Mail Code 017
Grand Rapids, MI 49508-3605
Phone
(616) 455-7300
NPI assigned
Jul 6, 2010
Last updated
Jul 6, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALHT CONTINUING CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Lawrence J Oberst, CPA
Title
SHCC/Director of Finance
Phone
(616) 486-2405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X Primary

Addresses

Primary practice location

4130 Kalamazoo Ave SE
Mail Code 017
Grand Rapids, MI 49508-3605

Mailing address

750 Fuller Ave NE
Mail Code 133
Grand Rapids, MI 49503-1918
Phone (616) 455-7300

Other names 1

  • Spectrum Health Neuro Rehab Services-Residential Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health Neuro Rehab Services-Rehab3 organizations share this tax ID, including this one
Part of
Elder Consult

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4130 Kalamazoo Ave SE
#17
Grand Rapids, MI 49508
Phone (616) 455-7300

750 Fuller Ave NE
#133
Grand Rapids, MI 49503

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1164734364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 FULLER AVE NE",
            "address_2": "MAIL CODE 133",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-455-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 KALAMAZOO AVE SE",
            "address_2": "MAIL CODE 017",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495083605",
            "telephone_number": "616-455-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH WORTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALHT CONTINUING CARE",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "OBERST",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SHCC/DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "616-486-2405",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Health Neuro Rehab Services-Residential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.