| NPI | 1619749025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY LYNNE KOWALCZYK Owner 616-773-1478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-30 |