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PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1376554519


NPI Information

NPI: 1376554519
Provider Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Classification: Physician Assistant - 363A00000X
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 physician assistant in Grand Rapids, MI. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI is 1376554519. 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 Manage Care Administrator and has the following contact phone number (616) 281-6372.

The enumeration date for this NPI number is 8/11/2006 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
1363A00000XPhysician AssistantYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.