| NPI | 1609930130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MARQUESS Program Director 269-344-0202 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-12-02 |