| NPI | 1457353146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J. SHUMWAY Executive Director 269-945-2942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 080001) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2020-08-22 |