| NPI | 1508096710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JO CARLTON Therapist 616-224-7617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6801091422) |
| Additional Taxonomies | 251B00000X Case Management (Licence: MI 6801091422) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2009-07-22 |