| NPI | 1083420665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN FOX Counselor 269-986-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2026-05-07 |