| NPI | 1144079518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYMI HARGROVE Llmsw 616-970-4661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |