NPIMap

Organization Active NPI

Mary Free Bed Sub-Acute Rehabilitation

  • Skilled Nursing Facility
  • Grand Rapids, MI
National Provider Identifier
1285019802
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MARY FREE BED SUB-ACUTE REHABILITATION
Practice address
235 Wealthy St SE
5TH Floor
Grand Rapids, MI 49503-5247
Phone
(616) 840-8330
NPI assigned
Jul 24, 2015
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Pamela Latovick
Title
VP Reimbursement
Phone
(734) 343-6628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

235 Wealthy St SE
5TH Floor
Grand Rapids, MI 49503-5247

Mailing address

235 Wealthy St SE
5TH Floor
Grand Rapids, MI 49503-5247
Phone (616) 840-8330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811005579 MI Part A Provider - Skilled Nursing Facility 7416262027 Practice locations: Grand Rapids, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285019802. Details of each certification follow.

Skilled nursing facility certification: CCN 235708

Legal name
MARY FREE BED SUB-ACUTE REHABILITATION
Doing business as
MARY FREE BED SUB-ACUTE REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Sep 30, 2015
Last certification
Apr 16, 2025
Beds
48
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 2013 in MI
Enrollment address
235 Wealthy St SE
# 5
Grand Rapids, MI 49503-5247
Nursing home name
MARY FREE BED SUB-ACUTE REHABILITATION
Affiliated entity
TRINITY HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mary Free Bed Sub-Acute RehabilitationCCN 235708 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Sep 30, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4846.7 residents per day on average
Chain
Trinity Health19 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2097285Mary Free Bed Sub Acute Rehabilitation235 Wealthy Street SE 5TH Floor, Grand Rapids, MI 49503Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

235 Wealthy St SE
#5
Grand Rapids, MI 49503
Phone (616) 840-8930

235 Wealthy St SE
Fl 5
Grand Rapids, MI 49503
Phone (616) 840-8162

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kiersten M Cudney Individual Operational/Managerial ControlAdministrator Oct 1, 2022
Trinity Continuing Care Services Organization, Livonia, MI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2015 50%
Marcus a Bowens Individual Corporate DirectorBoard Member Dec 1, 2022
Bruce Brasser Individual Corporate DirectorBoard Member Jan 1, 2015
Nathaniel Guzman Individual Corporate DirectorBoard Member Dec 1, 2022
Stacey Johnson Individual Corporate OfficerVice Chair Dec 1, 2022
Corporate DirectorBoard Member Dec 1, 2022
Mary Free Bed Rehabilitation Hospital Organization, Grand Rapids, MI Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2015 50%
Leeann Pennington Individual Corporate DirectorBoard Member Dec 1, 2022
Pamela S Latovick Individual Corporate DirectorVP Reimbursement Jul 1, 2018
Meg Treat Individual Corporate DirectorBoard Member Dec 1, 2022
Ralph Wang Individual Corporate OfficerChair Dec 1, 2022
Corporate DirectorBoard Member Dec 1, 2022
Trinity Health Corporation Organization, Livonia, MI Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2015 50%
Ingrid Cheslek Individual Corporate DirectorBoard Member Feb 1, 2023

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 164

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 164

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

  • Ralph Wang, MD
    • Physical Medicine & Rehabilitation Physician
    • Grand Rapids, MI
    • NPI 1679744833
    NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1285019802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "address_2": "5TH FLOOR",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "address_2": "5TH FLOOR",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY FREE BED SUB-ACUTE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "LATOVICK",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "VP REIMBURSEMENT",
        "authorized_official_telephone_number": "734-343-6628"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.