| NPI | 1396247235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SUPERSON Clinical Lmsw 231-715-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MI 6801100021) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-03-26 |