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 |