| NPI | 1063887230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANN HADERER Office Manager 231-348-5018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 4301089286) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |