Pine Rest Christian Mental Heatth Services
NPI #1508875667 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1508875667
- Entity Type
- Organization
- Organization Name
- Pine Rest Christian Mental Heatth Services
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PINE REST CHRISTIAN MENTAL HEALTH SERVICES
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Aug 7, 2006
- Last Updated
- Nov 4, 2020
Practice Location
- Address
- 310 LAFAYETTE AVE SE
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49503-4693
- Phone
- (616) 913-1400
Authorized Official
- Name
- DIANE FENNEMA
- Title
- MANAGED CARE ADMINISTRATOR
- Phone
- (616) 281-6372
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist |
| Social Worker |
| Physician Assistant |
| Nurse Practitioner |
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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