Christian Haven Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AH700236766 Issued in MI

Legal business name

CHRISTIAN HAVEN HOME

Practice address

704 Pennoyer Ave
Grand Haven, MI 49417-1851

Phone

(616) 842-0170

Fax

(616) 842-4886

NPI assigned

Apr 30, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Leeanne N Dixon

Title

Administrator

Phone

(616) 842-0170

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1235497009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 PENNOYER AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171851",
            "telephone_number": "616-842-0170",
            "fax_number": "616-842-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 PENNOYER AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171851",
            "telephone_number": "616-842-0170",
            "fax_number": "616-842-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN HAVEN HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "LEEANNE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "616-842-0170",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AH700236766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1771940",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Chapman
• Saige Emma Chapman
• Michayla Chciuk
• Katherine A Childs
• Morgan Chorak, CNS
• Anna Eileen Ciarlino, ATC
• Sydney Tressler Cinal, DDS
• Clarity Health Services (Comprehensive Ear and Hearing of Grand Haven)
• Julie Clark, MSPT
• Cmbi3 PLLC (Grand Haven Pediatric Dentistry)

• Assisted Living Facility in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.