Grace Haven Assisted Living LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

23D1102195 Issued in MI

Legal business name

GRACE HAVEN ASSISTED LIVING LLC

Doing business as

Grace Haven Assisted Living - Laboratory

Practice address

1507 Glastonbury Dr
Saint Johns, MI 48879-8235

Phone

(989) 224-1650

NPI assigned

Mar 31, 2010

Last updated

Mar 23, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas Nobel

Title

President

Phone

(989) 224-1650

Specialties & licenses 1

Addresses

Other names 1

• Grace Haven Assisted Living - Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1053636167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 GLASTONBURY DR",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488798235",
            "telephone_number": "989-224-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 GLASTONBURY DR",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488798235",
            "telephone_number": "989-224-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HAVEN ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-31",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "NOBEL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-224-1650"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D1102195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Haven Assisted Living - Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory R Glatz, DO
• Heidi Jo Glew, LMSW
• David Jon Goeckel, DDS
• Robert Goerge, ATC
• Grace Haven Assisted Living
• Charles Peter Graham, D.C.
• Holly Graham
• Stephanie Hadley, LMSW, IMH-E
• Jessica Kristie Hafner, ATC/L
• Samantha Hallenbeck, DPT

• Clinical Medical Laboratory in Saint Johns, MI
• Providers in Saint Johns, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.