| NPI | 1619244969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L WIEGAND Owner 231-727-2901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801080675) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |