| NPI | 1316340094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA BLACKMON CEO 616-965-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2018-04-04 |