# PINE LAKE FUND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669389524
- **Authorized official:** DR. TIFFANY BETTY WHITE PHD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (269) 598-0636

## Contact information

- **Practice address:** 11825 PINE LAKE RD, PLAINWELL, MI 49080-9218
- **Practice address phone:** (269) 598-0636
- **Mailing address:** 11825 PINE LAKE RD, PLAINWELL, MI 49080-9218
- **Mailing address phone:** (269) 598-0636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/26/2026
- **Last updated:** 08/26/2026