| NPI | 1649459132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE CARTER Clinical Director Owner 269-657-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2011-11-19 |