| NPI | 1376169474 |
|---|---|
| Doing Business As | CHGVH TM CLINIC TRI COUNTY CITY HS |
| Entity Type | Organization |
| Authorized Contact | ELISABETH LACEY Credentialing Mgr 616-486-6630 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2023-09-05 |