| NPI | 1225910664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LAYLIN Reimbursement Office Manager 269-925-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |