| NPI | 1225376056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALLEN DERROR Executive Director 231-878-3059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301013463) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |