| NPI | 1104717941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN VOLMERING Administrative Specialist 989-817-2905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2026-07-21 |