| NPI | 1508228966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN R BERTLING-SAFFORD Owner 616-920-0823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-12-28 |