NPIMap

Organization Active NPI

Fountain Hill Center -- Lakeshore Office

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
National Provider Identifier
1568866754
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FOUNTAIN HILL CENTER -- LAKESHORE OFFICE
Practice address
534 Fountain St NE
Grand Rapids, MI 49503-3422
Phone
(616) 456-1178
NPI assigned
Oct 16, 2014
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
FOUNTAIN HILL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy Van Gunst, M.A., L.P.C.
Title
Executive Coordinator
Phone
(616) 456-1178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MI Primary

Addresses

Primary practice location

534 Fountain St NE
Grand Rapids, MI 49503-3422

Mailing address

PO Box 32
New Era, MI 49446-0032
Phone (616) 456-1178

National Provider Directory

National Provider Directory
Tax ID family
Fountain Hill Center2 organizations share this tax ID, including this one
Part of
Fountain Hill Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1568866754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "NEW ERA",
            "state": "MI",
            "postal_code": "494460032",
            "telephone_number": "616-456-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 FOUNTAIN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033422",
            "telephone_number": "616-456-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN HILL CENTER -- LAKESHORE OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUNTAIN HILL CENTER",
        "enumeration_date": "2014-10-16",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "VAN GUNST",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "EXECUTIVE COORDINATOR",
        "authorized_official_telephone_number": "616-456-1178",
        "authorized_official_credential": "M.A., L.P.C."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.