| NPI | 1114367380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CHERI DINGWELL Director 517-667-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801092564) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2023-10-24 |