| NPI | 1093933210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R TERRENTINE Executive Director 269-343-6185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 390183) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |