Pine Rest Christian Mental Heatth Services | |
310 Lafayette Ave Se Grand Rapids MI 49503-4693 | |
(616) 913-1400 | |
Not Available |
Full Name | Pine Rest Christian Mental Heatth Services |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 310 Lafayette Ave Se, 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 Heatth Services 300 68th St Se Grand Rapids MI 49548-6927 Ph: (616) 455-5000 | Pine Rest Christian Mental Heatth Services 310 Lafayette Ave Se Grand Rapids MI 49503-4693 Ph: (616) 913-1400 |
NPI Number | 1508875667 |
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Provider Enumeration Date | 08/07/2006 |
Last Update Date | 11/04/2020 |
Certification Date | 11/04/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508875667 | NPI | - | NPPES |
500D11133 | Other | MI | NURSE PRACT. |
800D16222 | Other | MI | SOCIAL WORKERS |
260D17625 | Other | MI | PSYCHIATRISTS |
P10D11275 | Other | MI | PSYCHOLGOGISTS-MA, DOCTOR |
680D16189 | Other | MI | PSYCHOLOGISTS |
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