PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI 1841791357

NPI Information

NPI: 1841791357
Provider Name: PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
300 68TH STREET SE
GRAND RAPIDS, MI
ZIP 49548
Phone: (616) 281-6372
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PINE REST CHRISTIAN MENTAL HEALTH SERVICES is an addiction (substance use disorder) counselor in Grand Rapids, MI. PINE REST CHRISTIAN MENTAL HEALTH SERVICES NPI is 1841791357. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 68TH STREET SE
GRAND RAPIDS, MI
ZIP 49548
Phone: (616) 281-6372

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

The enumeration date for this NPI number is 2/21/2018 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	SA0410417	MICHIGAN	Yes
2	324500000X	Substance Abuse Rehabilitation Facility		SA0410417	MICHIGAN	No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SA0410417	OTHER	MICHIGAN	BC/BS SUBSTANCE ABUSE - CAMPUS CLINIC 1

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

NPI Synchronization or Removal

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