| NPI | 1427569763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET MARIE GLAES Owner 269-359-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 6401004300) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |