Provider Demographics
NPI:1376940122
Name:FOREST HILLS PSYCHIATRIC PLC
Entity Type:Organization
Organization Name:FOREST HILLS PSYCHIATRIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-942-9610
Mailing Address - Street 1:PO BOX 1608
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-1608
Mailing Address - Country:US
Mailing Address - Phone:800-968-6866
Mailing Address - Fax:616-532-7230
Practice Address - Street 1:1055 MEDICAL PARK DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3607
Practice Address - Country:US
Practice Address - Phone:800-949-8439
Practice Address - Fax:616-532-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D12824OtherBCBS
MI0D12824OtherBCBS