| NPI | 1578828083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRESTON R SMITH Treasurer 269-792-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-11-09 |