Organization Active NPI

Pine Way Group

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Kalamazoo, MI
National Provider Identifier
1720759046
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
PINE WAY GROUP
Doing business as
The Pine Way Group
Practice address
1276 Jack Pine Dr
Kalamazoo, MI 49006-5499
Phone
(616) 214-9142
NPI assigned
Sep 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Mr. Mark Frank
Title
Owner
Phone
(616) 214-9142

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1276 Jack Pine Dr
Kalamazoo, MI 49006-5499

Mailing address

7667 Crooked Cove St
Kalamazoo, MI 49009-4073
Phone (616) 214-9142

Other names 1

  • The Pine Way Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1720759046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7667 CROOKED COVE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490094073",
            "telephone_number": "616-214-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 JACK PINE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065499",
            "telephone_number": "616-214-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE WAY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-214-9142",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pine Way Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.