| NPI | 1508294901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON L GROH Owner/Counselor 269-921-3643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6410103838) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2013-10-22 |