| NPI | 1124765235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA BULLARD Clinical Social Worker 231-598-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-05-25 |