| NPI | 1104202209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD L GROOTERS CEO/President 616-560-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801061511) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |