| NPI | 1679369995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE WILSON Owner 616-635-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-04-15 |