Provider Demographics
NPI:1639561848
Name:PINES BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:PINES BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-279-8404
Mailing Address - Street 1:200 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1776
Mailing Address - Country:US
Mailing Address - Phone:517-278-3791
Mailing Address - Fax:517-279-8172
Practice Address - Street 1:200 VISTA DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036
Practice Address - Country:US
Practice Address - Phone:517-278-3791
Practice Address - Fax:517-279-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health