# HEATHCLIFFE HAVEN ASSISTED LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366981631
- **Authorized official:** MR. BRADFORD OAKLEY MARTELL (OWNER/LICENSEE)
- **Authorized official phone:** (616) 402-0477

## Contact information

- **Practice address:** 2611 HEATHCLIFF ST SE, GRAND RAPIDS, MI 49546-5621
- **Practice address phone:** (616) 570-0818
- **Practice address fax:** (616) 570-0818
- **Mailing address:** 2752 SCHINDLER DR NW, GRAND RAPIDS, MI 49544-9115
- **Mailing address phone:** (616) 402-0477
- **Mailing address fax:** (616) 228-4398

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | AS410380386 | MI | Yes |

## Other

- **Enumeration date:** 02/19/2017
- **Last updated:** 02/19/2017