NPIMap

Organization Active NPI

Pine Rest Christian Mental Health Services

  • Psychiatric Hospital
  • Grand Rapids, MI
National Provider Identifier
1982672762
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 455-5270
Fax
(616) 281-6459
NPI assigned
Mar 9, 2006
Last updated
Nov 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Ryan LarueNPI 1902904188
Title
VP Contracting
Phone
(616) 281-6373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU
Social Worker 104100000X NU
Anesthesiology Physician 207L00000X NU
Internal Medicine Physician 207R00000X NU
Psychiatry Physician 2084P0800X NU
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Psychiatric Hospital 283Q00000X NU Primary
Psychiatric Residential Treatment Facility 323P00000X NU
Substance Abuse Rehabilitation Facility 324500000X NU
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

300 68TH St SE
PO Box 165
Grand Rapids, MI 49548-6927
Phone (616) 281-6372

Other identifiers 2

IdentifierTypeStateIssuer
1556812MedicaidMI
00290OtherMIBC/BS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PineRestCMHS@directaddress.pinerest.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070328000183 MI Part A Provider - Hospital 4981506508 Practice locations: Grand Rapids, MI; Zeeland, MI; Holland, MI; Hastings, MI; Grandville, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982672762. Details of each certification follow.

Hospital certification: CCN 234006

Legal name
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Sep 17, 2010
Beds
118 (106 certified)
Ownership / control type
Federal
Organization structure
CorporationNon-profit
Incorporated
Jun 12, 1993 in MI
Enrollment address
300 68TH St SE
Grand Rapids, MI 49548-6927
Main/Primary Hospital Location
Hospital subgroups
General, Psychiatric

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Pine Rest Christian Mental Health ServicesCCN 234006 · All quality measures
Type
Psychiatric
Ownership
Government - Federal
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Pine Rest CHR M H S42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Interoperability endpoints

  • Direct secure messaging: pinerestcmhs@directaddress.pinerest.org

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steven Ender Individual Corporate DirectorBoard Member Aug 27, 2025
Paul Karsten Individual Corporate DirectorChief Financial Officer Feb 14, 2007
W-2 Managing Employee Oct 10, 2010
Douglas Josephson Individual Corporate DirectorBoard Member Aug 25, 2022
Hermina a Breuker Individual Corporate DirectorBoard Member Aug 25, 2022
Jody Vanderwel Individual Corporate DirectorBoard Member Sep 1, 2020
Robert Connors Individual Corporate DirectorBoard Member Aug 25, 2022
Mary Cartwright Individual Corporate DirectorBoard Member Aug 25, 2022
Mark C Eastburg Individual 5% Or Greater Direct Ownership InterestCeo Oct 28, 2014
Corporate Director Jan 1, 2007
W-2 Managing Employee Oct 10, 2010
Brett Holleman Individual Corporate DirectorBoard Member Aug 25, 2022

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1982672762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "address_2": "PO BOX 165",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-281-6372",
            "fax_number": "616-281-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5270",
            "fax_number": "616-281-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE REST CHRISTIAN MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "LARUE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "VP CONTRACTING",
        "authorized_official_telephone_number": "616-281-6373"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1556812",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00290",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PineRestCMHS@directaddress.pinerest.org",
            "affiliation": "N",
            "address_1": "300 68th St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495486927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.