NPI | 1235895897 |
---|---|
Other Name | PINE REST COMMUNITY SERVICES SUBSTANCE ABUSE |
Entity Type | Organization |
Authorized Contact | DIANE M FENNEMA Managed Care Administrator 616-281-6372 |
Organization Subpart ? | No |
Primary Taxonomy | 283Q00000X Psychiatric Hospital |
Additional Taxonomies | 101YP2500X Counselor, Professional |
103T00000X Psychologist | |
103TC0700X Psychologist, Clinical | |
1041C0700X Social Worker, Clinical | |
2084A0401X Psychiatry & Neurology, Addiction Medicine | |
2084P0800X Psychiatry & Neurology, Psychiatry | |
363L00000X Nurse Practitioner | |
324500000X Substance Abuse Rehabilitation Facility | |
363A00000X Physician Assistant | |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2021-11-09 |
Last Update Date | 2022-03-11 |