Pine Rest Christian Mental Health Services

LBN: Pine Rest Christian Mental Health Services
Pine Rest Christian Mental Health Services is an health care organization with primary practice located at 243 68Th St Se , Grand Rapids MI 49548-6924. The organization recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Social Worker, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. Pine Rest Christian Mental Health Services can be contacted via phone (616) 281-6836, or through Fennema, Diane via phone (616) 281-6372.

Contact Information

Primary practice address
243 68Th St Se Grand Rapids MI 49548-6924
Phone: (616) 281-6836
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fennema, Diane
Phone: (616) 281-6372

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X 410334 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1679777049
LBN Legal business name Pine Rest Christian Mental Health Services
DBA Doing business as
Authorized official Fennema, Diane
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 12th, 2007
Last updated Nov 4th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679777049 NPPES
Michigan Other 750920290 BCBS DETOX

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