23D2073376 CLIA NUMBER - GRAND PINES ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 23D2073376

Facility Name: GRAND PINES ASSISTED LIVING

Facility Address:
1410 S FERRY
GRAND HAVEN, MI
ZIP 49417
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Facility Phone Number: 616 850-2150

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1124454053

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	23D2073376
LAB Type	Assisted Living Facility
Facility Name	GRAND PINES ASSISTED LIVING
Street	1410 S FERRY
City	GRAND HAVEN
State	MI
ZIP	49417
Phone	616 850-2150
CertificateType	4
CertificateEffectiveDate	2/18/2024
CertificateExpirationDate	2/17/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024