| NPI | 1174690648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED E. WIGEN President CEO 989-777-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 730174) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 730174) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-01-02 |