Provider Demographics
NPI:1023477478
Name:MARY FREE BED AT HOME, LLC
Entity type:Organization
Organization Name:MARY FREE BED AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-524-6401
Mailing Address - Street 1:5440 CORPORATE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2646
Mailing Address - Country:US
Mailing Address - Phone:866-402-9000
Mailing Address - Fax:
Practice Address - Street 1:2944 FULLER AVE NE STE 301
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-3784
Practice Address - Country:US
Practice Address - Phone:855-602-2500
Practice Address - Fax:855-632-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-14
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health