Rest Haven Homes Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AH410236876 Issued in MI

Legal business name

REST HAVEN HOMES INC

Practice address

1424 Union Ave NE
Grand Rapids, MI 49505-5197

Phone

(616) 363-6819

Fax

(616) 363-1658

NPI assigned

Nov 28, 2011

Last updated

Nov 28, 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

Terry Ruth Carrick, NHA

Title

Administrator of Finance

Phone

(616) 363-6819

Specialties & licenses 2

Addresses

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": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1548537103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 UNION NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055197",
            "telephone_number": "616-363-6819",
            "fax_number": "616-363-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 UNION AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055197",
            "telephone_number": "616-363-6819",
            "fax_number": "616-363-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REST HAVEN HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "CARRICK",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "ADMINISTRATOR OF FINANCE",
        "authorized_official_telephone_number": "616-363-6819",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AH410236876",
            "primary": true
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MI",
            "license": "1070000412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.