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Organization

CHRISTIAN HAVEN HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LEEANNE N DIXON (ADMINISTRATOR)
(616) 842-0170
Entity
Organization

Contact information

Practice address
704 PENNOYER AVE, GRAND HAVEN, MI 49417-1851
(616) 842-0170
(616) 842-4886
Mailing address
704 PENNOYER AVE, GRAND HAVEN, MI 49417-1851
(616) 842-0170
(616) 842-4886

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AH700236766
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1771940
MI
Enumeration date
04/30/2012
Last updated
04/30/2012
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