| NPI | 1245651405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS CHURCHWELL CEO 231-728-2138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MI SA0610022) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI SA0610022) |
| 103TC0700X Psychologist, Clinical (Licence: MI SA0610022) | |
| 103TC1900X Psychologist, Counseling (Licence: MI SA0610022) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI SA0610022) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0610022) | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |