| NPI | 1205140142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN LEE JOHNSON President 231-929-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2023-11-06 |