PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI# 1821414566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821414566 |
| Entity Type | Organization |
| Organization Name | PINE REST CHRISTIAN MENTAL HEALTH SERVICES |
| Practice Address |
1350 W Centre Ave Portage MI 49024-5361 |
| Mailing Address |
300 68th St Se Grand Rapids MI 49548-6927 |
| Practice Telephone | 2699107327 |
| Practice Fax Number | 2699107328 |
| Mailing Telephone | 6164555000 |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DIANE FENNEMA (MANAGED CARE ADMINISTRATOR) |
| Authorized Official Telephone | 6162816372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | SA0390191 | MI | Residential Treatment Facilities |
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 283Q00000X | Psychiatric Hospital | 1080000018 | MI | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154339521 | Pine Rest Christian Mental Health Services | Psychologist | 550 - 3 Mile Rd Nw, Grand Rapids, MI 49544-1673 | 2006-08-03 |
| 1841791357 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 300 68th Street Se, Grand Rapids, MI 49548 | 2018-02-21 |
| 1952818551 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 450 Meadow Run Dr, Hastings, MI 49058-9053 | 2018-01-04 |
| 1619341310 | Pine Rest Christian Mental Health Services | Counselor | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2015-11-18 |
| 1598138810 | Pine Rest Christian Mental Health Services | Counselor | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2015-11-09 |
| 1386015683 | Pine Rest Christian Mental Health Services | Counselor | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2015-10-13 |
| 1467840553 | Pine Rest Christian Mental Health Services | Nurse Practitioner | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2014-12-26 |
| 1467873414 | Pine Rest Christian Mental Health Services | Speech-Language Pathologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2013-12-18 |
| 1427216241 | Pine Rest Christian Mental Health Services | Counselor | 4294 Laurel Dr, Lake Odessa, MI 48849-9423 | 2008-05-29 |
| 1487837506 | Pine Rest Christian Mental Health Services | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2007-12-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | 300 68th St Se, Grand Rapids, MI 49548-6927 |
| Iowa Business Entities | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | 300 68th St Se, Grand Rapids, MI 49548 |
| Street Address |
1350 W CENTRE AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-5361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821172685 | Hac Hearing Aid Centers of America Inc | Audiologist | 1350 W Centre Ave, Suite 105, Portage, MI 49024-5361 | 2006-10-25 |
| 1730591306 | Connect Hearing, Inc. | Audiologist | 1350 W Centre Ave, Ste 105, Portage, MI 49024-5361 | 2014-05-29 |
| 1225383375 | Bernice S Patterson | Psychologist | 1350 W Centre Ave, Portage, MI 49024-5361 | 2012-07-16 |
| 1427368836 | Amelia Rose Tornow-schuring | Audiologist-Hearing Aid Fitter | 1350 W Centre Ave, Suite 105, Portage, MI 49024-5361 | 2010-10-19 |
| 1083943203 | Charmeka S Newton | Counselor | 1350 W Centre Ave, Portage, MI 49024 | 2009-12-17 |
| 1710191960 | Tlc Laser Center of Kalamazoo, LLC | Clinic/Center | 1350 W Centre Ave, Ste. 110, Portage, MI 49024-5361 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285277814 | Lansing Senior Partners LLC | Psychiatric Hospital | 3512 Coolidge Rd, East Lansing, MI 48823-6376 | 2019-10-27 |
| 1336498013 | Genesys Hillside Behavioral Services | Psychiatric Hospital | 4396 Meadows Ave, Grand Blanc, MI 48439-8689 | 2012-09-10 |
| 1275727653 | Head To Mind Psychiatric Services Inc | Psychiatric Hospital | 19450 Argyle Cres, Detroit, MI 48203-1402 | 2007-08-29 |
| 1629108766 | Circle of Life | Psychiatric Hospital | 24080 Seneca St, Oak Park, MI 48237-3725 | 2007-03-07 |
| 1205973922 | Circle of Life Psychiatric Hospital | Psychiatric Hospital | 403 Village Green Blvd, Apt 106, Ann Arbor, MI 48105-3612 | 2007-01-31 |
| 1588672406 | T & G Corporation Inc | Psychiatric Hospital | 4050 E 12 Mile Rd, Warren, MI 48092-2534 | 2006-08-04 |
| 1053342220 | Havenwyck Hospital Inc | Psychiatric Hospital | 1525 University Dr, Auburn Hills, MI 48326-2673 | 2006-07-06 |
| 1710918362 | Henry Ford Health System | Psychiatric Hospital | 10300 W 8 Mile Rd, Ferndale, MI 48220-2100 | 2006-07-05 |
| 1033108832 | Triangle Industries Inc | Psychiatric Hospital | 15000 Gratiot Ave, Detroit, MI 48205-1973 | 2005-10-14 |
| 1053841650 | Havenwyck Hospital Inc | Psychiatric Hospital | 101 W Townsend Rd, St Johns, MI 48879 | 2017-06-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PINE REST CHRISTIAN MENTAL HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.