| NPI | 1629668587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CHRISTOPHER DEBOER Clinical Director 517-918-4371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2021-01-24 |