Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifeline Interventional Therapeutics, PLLC

Organization Addiction Medicine (Psychiatry & Neurology) Physician · NPI 1912726811

Lifeline Interventional Therapeutics, PLLC is an Addiction Medicine (Psychiatry & Neurology) Physician in Grand Rapids, Michigan. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1179 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-3682
Phone: (616) 400-5433
Fax: (616) 360-2034
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X
Addiction Medicine (Psychiatry & Neurology) Physician Taxonomy 2084A0401X
Pain Medicine (Psychiatry & Neurology) Physician Taxonomy 2084P2900X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1912726811
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Vanlonkhuyzen — Partner/Physician Assistant · (616) 400-5433
NPI enumeratedOctober 8, 2024
Last updated in NPPESDecember 6, 2024
Certification dateDecember 6, 2024
Mailing address1179 E Paris Ave Se Ste 100, Grand Rapids, MI 49546-3682

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