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PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI 1679777049
Internal Medicine - Addiction Medicine in Grand Rapids, MI

Active since June 12, 2007
243 68TH ST SE, GRAND RAPIDS, MI 49548(616) 281-6836 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pine Rest Christian Mental Health Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI 1679777049) is a healthcare organization registered as an addiction medicine in Grand Rapids, Michigan and active in the NPI registry since June 2007. The organization lists Diane M Fennema, Managed Care Administrator, as its authorized official.

NPPES Registry Identity

NPI1679777049
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NamePINE REST CHRISTIAN MENTAL HEALTH SERVICES
Location Address243 68TH ST SEGrand Rapids, MI 49548-6924
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Phone(616) 281-6836
Organization SubpartYes
Authorized OfficialDiane M FennemaManaged Care Administrator · (616) 281-6372
Enumeration DateJune 12, 2007
Last NPPES UpdateJune 18, 2026
NPPES CertifiedJune 18, 2026
✔ NPI 1679777049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 13

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
Also ListedBehavior AnalystTaxonomy 103K00000X
Also ListedPsychologistTaxonomy 103T00000X
Also ListedSocial WorkerTaxonomy 104100000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedOccupational TherapistTaxonomy 225X00000X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X · License 410334 (MI)
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
243 68TH ST SE, Grand Rapids, MI 49548
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Other Identifiers 1

Other750920290MI · Bcbs Detox

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include WellPoint.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLENE MARIE HARABURDA MA, LLP, RSW
Psychologist
243 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 222-5180
JANICE EILEEN GRADY LMSW, LPC, MA, LLP
Psychologist
243 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 222-5180

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Rest Christian Mental Health Services's NPI number?

The NPI number for Pine Rest Christian Mental Health Services is 1679777049. It was assigned to this organization in the NPPES registry on June 12, 2007.

Where is Pine Rest Christian Mental Health Services located?

Pine Rest Christian Mental Health Services is located at 243 68th St SE, Grand Rapids, MI 49548. The listed phone number is (616) 281-6836.

What is Pine Rest Christian Mental Health Services's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

What insurance does Pine Rest Christian Mental Health Services accept?

Health plans from WellPoint list Pine Rest Christian Mental Health Services as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pine Rest Christian Mental Health Services was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 47 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.