| NPI | 1497520449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH ROSE KELLER Masters Level Clinical Therapist 269-369-1869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-02-13 |