| NPI | 1710066253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT DAVIS Deputy Director 269-553-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI SA0390177) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-03-17 |