| NPI | 1629430384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL LEE BADGEROW Therapist 989-316-5160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 1-0450) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |