| NPI | 1265320089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLY LACELLE Counseling Psychologist 269-366-8858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-10-09 |