| NPI | 1184133308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY H HAYATAKA Owner 616-325-5755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI SA0030042) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2017-09-20 |