Grand Rapids Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRAND RAPIDS OPCO, LLC

Practice address

2000 Leonard St NE
Grand Rapids, MI 49505-5837

Phone

(616) 458-1133

Fax

(616) 458-0743

NPI assigned

Jul 28, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Craig A Flashner

Title

LLC Member

Phone

(805) 819-3351

Specialties & licenses 1

Addresses

Other names 1

• Medilodge of Grand Rapids Doing business as

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1942936299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD STE 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8069",
            "fax_number": "866-360-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055837",
            "telephone_number": "616-458-1133",
            "fax_number": "616-458-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RAPIDS OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "FLASHNER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "805-819-3351",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medilodge of Grand Rapids",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medilodge of Grand Rapids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Grand Rapids Psychological Testing

• All providers in Grand Rapids, MI
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.