Provider Demographics
NPI:1518725688
Name:TRINITY HEALTH SPECIALTY HOSPITAL - GRAND HAVEN
Entity Type:Organization
Organization Name:TRINITY HEALTH SPECIALTY HOSPITAL - GRAND HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEYE
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-847-5269
Mailing Address - Street 1:1309 SHELDON RD FL 2 EAST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2404
Mailing Address - Country:US
Mailing Address - Phone:616-842-3600
Mailing Address - Fax:
Practice Address - Street 1:1309 SHELDON RD 2ND FL EAST
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2404
Practice Address - Country:US
Practice Address - Phone:616-758-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital