| NPI | 1295618635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTYNE LEE ORTQUIST Clinical Director 616-638-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 133N00000X Nutritionist |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-10-25 |