Provider Demographics
NPI: | 1437923729 |
---|---|
Name: | ADVENT REHABILITATION, LLC |
Entity type: | Organization |
Organization Name: | ADVENT REHABILITATION, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LEAVER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 616-356-5000 |
Mailing Address - Street 1: | 625 KENMOOR AVE SE STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | GRAND RAPIDS |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49546-2395 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 616-356-5000 |
Mailing Address - Fax: | 616-356-5001 |
Practice Address - Street 1: | 4085 BURTON ST SE STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | GRAND RAPIDS |
Practice Address - State: | MI |
Practice Address - Zip Code: | 49546-2444 |
Practice Address - Country: | US |
Practice Address - Phone: | 616-233-3599 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-11-08 |
Last Update Date: | 2025-05-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |