| NPI | 1740673698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN RENE' WADE-JONES President 269-350-5661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801087438) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-11-11 |