| NPI | 1487183455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M KLEIN Owner/Manager 231-342-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401009848) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2017-06-05 |