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HAVEN SPINE & PAIN CENTER PLLC NPI 1053901314


NPI Information

NPI: 1053901314
Provider Name: HAVEN SPINE & PAIN CENTER PLLC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 23D2235865

Address:
2680 LEONARD ST NE STE 3
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 364-4200
Get Directions

HAVEN SPINE & PAIN CENTER PLLC is an interventional pain medicine pain medicine in Grand Rapids, MI. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. HAVEN SPINE & PAIN CENTER PLLC NPI is 1053901314. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2680 LEONARD ST NE STE 3
GRAND RAPIDS, MI
ZIP 49525-902
Phone: (616) 364-4200
Fax: (616) 364-7347

The provider's authorized official is Jack Dillon .
The authorized official title is Executive Director and has the following contact phone number (312) 505-1033.

The CLIA number assigned to this NPI record is 23D2235865 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/21/2021 and was last updated on 12/9/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207LP2900XAnesthesiologyPain MedicineNo
2208VP0000XPain MedicinePain MedicineNo
3208VP0014XPain MedicineInterventional Pain MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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