| Pine Rest Community Services Substance Abuse | |
|
320 Commerce Ave Sw Grand Rapids MI 49503-4101 | |
| (616) 258-7599 | |
| Not Available |
| Full Name | Pine Rest Community Services Substance Abuse |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 320 Commerce Ave Sw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Diane M 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 Community Services Substance Abuse 300 68th St Se Grand Rapids MI 49548-6927 Ph: (616) 281-6372 | Pine Rest Community Services Substance Abuse 320 Commerce Ave Sw Grand Rapids MI 49503-4101 Ph: (616) 258-7599 |
| NPI Number | 1235895897 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235895897 | NPI | - | NPPES |
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