| NPI | 1306279740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY HALEY Director Of Operations 616-901-2986 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI AH800315846) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |