| NPI | 1275938805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY SUE REIDZANS Office Manager 616-459-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801089574) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |