Organization
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Active
Organization
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Active
Parent organization
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Authorized official
DIANE FENNEMA (VP OF GENERAL SERVICES)
(616) 281-6372
Entity
Organization
Contact information
Practice address
1445 SHELDON RD, HARBOR DUNES HEALTH CENTER, GRAND HAVEN, MI 49417-2480
(616) 847-5145
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260D17625
PSYCHIATRISTS
MA
01
—
500D11133
NURSE PRACTICTIONER
MA
01
—
680D16189
PSYCHOLOGISTS
MI
01
—
800D16222
SOCITAL WORKERS
MA
01
—
P10D11275
PSYCHOLOGISTS
MI
Enumeration date
08/07/2006
Last updated
11/04/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up