| NPI | 1588906119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DEBRUYN Owner 231-715-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI 6801089389) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 6801089389) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 6801089389) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 6801089389) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-03-21 |