| NPI | 1497716047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROBERT MARTIN CEO 231-947-8110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 280001) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-08-22 |