| NPI | 1639188709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN JEANETTE BALLINGER Owner 989-779-9449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801084226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-00728) |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2018-01-11 |