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PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1487837506


NPI Information

NPI: 1487837506
Provider Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
300 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548
Phone: (616) 455-5000
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PINE REST CHRISTIAN MENTAL HEALTH SERVICES is a pediatrics in Grand Rapids, MI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI is 1487837506. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548-927
Phone: (616) 455-5000

The provider's authorized official is Diane Fennema .
The authorized official title is Managed Care Administator and has the following contact phone number (616) 281-6372.

The enumeration date for this NPI number is 12/12/2007 and was last updated on 11/4/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologistNo
2104100000XSocial WorkerNo
3207R00000XInternal MedicineNo
4207RA0401XInternal MedicineAddiction MedicineNo
5208000000XPediatricsYes
62084A0401XPsychiatry & NeurologyAddiction MedicineNo
72084P0800XPsychiatry & NeurologyPsychiatryNo
8283Q00000XPsychiatric HospitalNo
9363A00000XPhysician AssistantNo
10363L00000XNurse PractitionerNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OD14837OTHERMICHIGANBC/BS GNERAL MEDICINE
2OD16083OTHERMICHIGANBC/BS PSYCHIATRY-MULTI SP
3OD16222OTHERMICHIGANBC/BS SOCIAL WORKER
4OD11133OTHERMICHIGANBC/BS NURSE PRACTIONER
5OD17625OTHERMICHIGANBC/BS PSYCHIATRY
6OD16189OTHERMICHIGANBC/BS PSYCHOLOGIST
7OD14836OTHERMICHIGANBC/BS PEDIATRICS
8OD11275OTHERMICHIGANBC/BS MA, LLP, DOCTORAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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