| NPI | 1528361060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE MULLETT Clinician 616-459-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MI 6801090829) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |