| NPI | 1629431713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT DAVID CARD Operations Manager 231-620-6788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005691) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI SA0280057) |
| 101YM0800X Counselor, Mental Health (Licence: MI SA0280057) | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 163W00000X Registered Nurse | |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0280084) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2018-07-16 |