| NPI | 1548893209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH LACEY Manager 616-486-6630 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2023-10-27 |