Healthcare Provider Details

I. General information

NPI: 1376477497
Provider Name (Legal Business Name): CHRISTEN GROENHOUT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ROYAL PARK DR
ZEELAND MI
49464-2040
US

IV. Provider business mailing address

1487 SHENANDOAH DR
ZEELAND MI
49464-7300
US

V. Phone/Fax

Practice location:
  • Phone: 616-741-9466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: