| NPI | 1679135438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL B BOAFO Lpn 616-481-9414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |