| NPI | 1124171954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE FENNEMA Managed Care Administator 616-281-6372 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 101Y00000X Counselor | |
| 103G00000X Clinical Neuropsychologist | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 1041S0200X Social Worker, School | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-11-04 |