# RESTHAVEN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RESTHAVEN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942239223
- **Legal business name:** RESTHAVEN
- **Authorized official:** DEEDRE VRIESMAN (CEO/PRESIDENT)
- **Authorized official phone:** (616) 796-3503

## Contact information

- **Practice address:** 280 W 40TH ST, HOLLAND, MI 49423
- **Practice address phone:** (616) 796-3600
- **Practice address fax:** (616) 796-3609
- **Mailing address:** 948 WASHINGTON AVE, HOLLAND, MI 49423-5205
- **Mailing address phone:** (616) 796-3500
- **Mailing address fax:** (616) 796-3508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 03-405 | MI | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 08/14/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09912 | BCBS | MI |
| 05 | — | 2587831 | — | MI |