| NPI | 1225392418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S. OLEXA Owner 616-560-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801046560) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-00610) |
| 101YP2500X Counselor, Professional (Licence: MI 6401000047) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |