| NPI | 1114784451 |
|---|---|
| Doing Business As | HERON RIDGE ASSOCIATES OF MICHIGAN |
| Entity Type | Organization |
| Authorized Contact | LESLIE JOHNSON CEO 704-506-6267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-13 |