| NPI | 1346743721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DAWN COLE-CONWAY Owner 269-220-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |