| NPI | 1558166587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ENSING Manager 616-745-4091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-02-14 |