| NPI | 1649581794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M WILLIAMS Credentialing Coordinator 989-922-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI ON34080) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-03-07 |