| NPI | 1720375157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS SHEA Excutive Director 616-776-2120 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 122300000X Dentist | |
| 207R00000X Internal Medicine | |
| 207W00000X Ophthalmology | |
| 208000000X Pediatrics | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |