| NPI | 1083475800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINNE CLANCY GRABER Owner 269-762-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2025-05-20 |