| NPI | 1700119302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KAY JOUPPI Owner 616-608-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4704089611) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 4704089611) |
| 163WA2000X Registered Nurse, Administrator (Licence: MI 4704089611) | |
| 171W00000X Contractor (Licence: MI 4704089611) | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |