| NPI | 1669815650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAINA WIRGAU Therapist 616-558-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 680194489) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-26 |