| NPI | 1659572444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GENE FATATO President 269-962-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401007576) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801087444) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |