CHRISTIAN HAVEN HOME NPI 1235497009

NPI Information

  • NPI: 1235497009
  • Provider Name: CHRISTIAN HAVEN HOME
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 23D2203760
  • Address: 704 PENNOYER AVE
    GRAND HAVEN, MI
    ZIP 49417
  • Phone: (616) 842-0170

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NPI Details

CHRISTIAN HAVEN HOME is an assisted living facility in Grand Haven, MI. The provider is 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. CHRISTIAN HAVEN HOME NPI is 1235497009. The provider is registered as an organization entity type.

The provider's business location address is:

704 PENNOYER AVE
GRAND HAVEN, MI
ZIP 49417-851
Phone: (616) 842-0170
Fax: (616) 842-4886

The provider's authorized official is Leeanne N Dixon .
The authorized official title is Administrator and has the following contact phone number (616) 842-0170.

The CLIA number assigned to this NPI record is 23D2203760 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2012 and was last updated on 4/30/2012.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityAH700236766MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11771940MEDICAIDMICHIGAN

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: 11/21/2025

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