Pine Rest Christian Mental Health Services in Grand Rapids - Addiction Medicine
Pine Rest Christian Mental Health Services - NPI 1487837506
Pine Rest Christian Mental Health Services is a Addiction Medicine in Grand Rapids, Michigan. Pine Rest Christian Mental Health Services practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Pine Rest Christian Mental Health Services is 1487837506. The last update date is 2020-11-04.
Pine Rest Christian Mental Health Services's current location address is 300 68th St Se, Grand Rapids, Michigan. You can contact this provider via phone number 6164555000. The mailing address for Pine Rest Christian Mental Health Services is 300 68th St Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pine Rest Christian Mental Health Services |
|---|---|
| Address | 300 68th St Se, Grand Rapids, Michigan |
| Phone Number | 6164555000 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGED CA |
|---|---|
| Authorized Official Name | Fennema Diane |
| Telephone Number | 6162816372 |
NPI Number Detail
| NPI Number | 1487837506 |
|---|---|
| Provider Enumeration Date | 2007-12-12 |
| Last Updated Date | 2020-11-04 |
Provider Mailing Address Detail
| Address | 300 68th St Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495486927 |
| Phone Number | 6164555000 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 2084A0401X |
|
Definition: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| OD16083 | MI | BC/BS PSYCHIATRY-MULTI SP | |
| OD16222 | MI | BC/BS SOCIAL WORKER | |
| OD14837 | MI | BC/BS GNERAL MEDICINE | |
| OD17625 | MI | BC/BS PSYCHIATRY | |
| OD16189 | MI | BC/BS PSYCHOLOGIST | |
| OD11275 | MI | BC/BS MA, LLP, DOCTORAL | |
| OD11133 | MI | BC/BS NURSE PRACTIONER | |
| OD14836 | MI | BC/BS PEDIATRICS |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Pine Rest Christian Mental Health Services by the Centers for Medicare & Medicaid Services?
The Pine Rest Christian Mental Health Services has been assigned the NPI (National Provider Identifier) 1487837506 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Pine Rest Christian Mental Health Services?
The Pine Rest Christian Mental Health Services is physically situated at 300 68Th St Se, in the city of Grand Rapids, state of MI, with the postal code 495486927.
What is the area of specialization for Pine Rest Christian Mental Health Services, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Pine Rest Christian Mental Health Services is Addiction Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 2084A0401X.
On what date did the Pine Rest Christian Mental Health Services receive its 1487837506 assignment from the Centers for Medicare & Medicaid Services?
The Pine Rest Christian Mental Health Services was assigned its 1487837506 by the Centers for Medicare & Medicaid Services on 2007-12-12.
When was the information pertaining to Pine Rest Christian Mental Health Services most recently updated or revised?
The details related to Pine Rest Christian Mental Health Services, including its address, specialty, and other relevant information, were last updated or revised on 2020-11-04.