| NPI | 1760058663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLY FRITSCH Clinical Social Worker 616-822-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |