| NPI | 1174075105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA BEANE Director Of Access 231-724-3625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801095121) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |