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 300 68Th Street Se , Grand Rapids MI 49548. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is the primary health care specialty. Pine Rest Christian Mental Health Services can be contacted via phone (616) 281-6372, or through Fennema, Diane via phone (616) 281-6372.

Contact Information

Primary practice address
300 68Th Street Se Grand Rapids MI 49548
Phone: (616) 281-6372
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 SA0410417 Michigan
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X SA0410417 Michigan

Profile Details

NPI number 1841791357
LBN Legal business name Pine Rest Christian Mental Health Services
DBA Doing business as
Authorized official Fennema, Diane
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2018
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 1841791357 NPPES
Michigan Other SA0410417 BC/BS SUBSTANCE ABUSE - CAMPUS CLINIC 1

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