| Pine Rest Christian Mental Health Services | |
|
550 - 3 Mile Rd Nw Grand Rapids MI 49544-1673 | |
| (616) 222-3720 | |
| Not Available |
| Full Name | Pine Rest Christian Mental Health Services |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 550 - 3 Mile Rd Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Diane Fennema (MANAGED CARE ADMINISTRATOR) |
| Authorized Official Contact | 6162816372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Rest Christian Mental Health Services 300 68th St Se Grand Rapids MI 49548-6927 Ph: (616) 455-5000 | Pine Rest Christian Mental Health Services 550 - 3 Mile Rd Nw Grand Rapids MI 49544-1673 Ph: (616) 222-3720 |
| NPI Number | 1154339521 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 11/04/2020 |
| Certification Date | 11/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154339521 | NPI | - | NPPES |
| 680D16189 | Other | MI | PSYCHOLOGISTS |
| P10D11275 | Other | MI | MA, LLP/DOCTORAL |
| 500D11133 | Other | MI | NURSE PRACTITIONER |
| 260D17625 | Other | MI | PSYCHIATRIST |
| 800D16222 | Other | MI | SOCIAL WORKER |
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