Provider Demographics
NPI:1588019319
Name:THE MEDICAL TEAM, INC.
Entity Type:Organization
Organization Name:THE MEDICAL TEAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-390-2300
Mailing Address - Street 1:400 ANN ST NW STE 104
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-2053
Mailing Address - Country:US
Mailing Address - Phone:616-965-2280
Mailing Address - Fax:616-930-4376
Practice Address - Street 1:400 ANN ST NW
Practice Address - Street 2:SUITE 104
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-2052
Practice Address - Country:US
Practice Address - Phone:616-965-2280
Practice Address - Fax:616-930-4376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1040000012251G00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes251G00000XAgenciesHospice Care, Community Based