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General NPI Number Information
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NPI Number | 1639561848
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Entity Type | Organization
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Legal Business Name | PINES BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 200 VISTA DR
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City | COLDWATER
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State | MI
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Zip | 49036
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Country | US
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Telephone | 517-278-3791
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Fax | 517-279-8172
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Provider Business Mailing Address
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Address Line | 200 VISTA DR
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City | COLDWATER
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State | MI
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Zip | 49036-1776
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Country | US
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Telephone | 517-278-3791
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Fax | 517-279-8172
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | SUE A ENOS
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Credential |
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Telephone | 517-279-8404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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