| NPI | 1336691039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT VANDERLOON Owner 989-772-1261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 4704171003) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |