GRAND PINES ASSISTED LIVING CENTER
NPI 1124454053
Assisted Living Facility in Grand Haven, MI

Q: What is Grand Pines Assisted Living Center's NPI number?

The NPI number for Grand Pines Assisted Living Center is 1124454053. It was assigned to this organization in the NPPES registry on September 24, 2013.

Q: What is Grand Pines Assisted Living Center's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since September 24, 2013CLIA 23D2073376 · Waiver

1410 S FERRY ST, GRAND HAVEN, MI 49417(616) 850-2150(616) 850-2158 Get Directions Write a Review

NPPES record last updated: September 24, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Grand Pines Assisted Living Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND PINES ASSISTED LIVING CENTER (NPI 1124454053) is a healthcare organization registered as an assisted living facility in Grand Haven, Michigan and active in the NPI registry since September 2013. The organization holds a CLIA Waiver certificate valid through February 17, 2028 and lists Scott A Reenders, Authorized Agent, as its authorized official.

NPPES Registry Identity

NPI1124454053

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameGRAND PINES ASSISTED LIVING CENTER

Location Address1410 S FERRY STGrand Haven, MI 49417-2711

Mailing Address1410 S Ferry StGrand Haven, MI 49417-2711 · (616) 850-2150 · Fax (616) 850-2158

Phone(616) 850-2150

Fax(616) 850-2158

Organization SubpartNo

Authorized OfficialScott A ReendersAuthorized Agent · (616) 842-2425

Enumeration DateSeptember 24, 2013

✔ NPI 1124454053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in MI · AH700299440

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1410 S FERRY ST, Grand Haven, MI 49417

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2073376

Grand Pines Assisted Living · Grand Haven, MI

Active · expires Feb 17, 2028

CLIA Number23D2073376

Laboratory TypeAssisted Living Facility

Certificate Effective DateFebruary 18, 2026

Certificate Expiration DateFebruary 17, 2028

Laboratory DirectorAmi L. Moy

Laboratory Phone(616) 850-2150

Laboratory LocationGrand Pines Assisted Living1410 S Ferry, Grand Haven, MI 49417

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Pines Assisted Living Center's NPI number?

The NPI number for Grand Pines Assisted Living Center is 1124454053. It was assigned to this organization in the NPPES registry on September 24, 2013.

Where is Grand Pines Assisted Living Center located?

Grand Pines Assisted Living Center is located at 1410 S Ferry St, Grand Haven, MI 49417. The listed phone number is (616) 850-2150.

What is Grand Pines Assisted Living Center's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Grand Pines Assisted Living Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2073376) is associated with this NPI, valid through February 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grand Pines Assisted Living Center was last updated on September 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.