| NPI | 1407420573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY JO PUTNAM Manager 269-612-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist |
| Additional Taxonomies | 174H00000X Health Educator |
| 175T00000X Peer Specialist | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 226000000X Recreational Therapist Assistant | |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |