| NPI | 1881129716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIYOI J CRAIG Lmsw Clinical Therapist 616-281-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092618) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2022-07-21 |