| NPI | 1891346441 |
|---|---|
| Former Legal Business Name | GREAT LAKES BEHAVIOR MANAGEMENT SPECIALISTS, INC. |
| Entity Type | Organization |
| Authorized Contact | DAVID M GROFF President 574-231-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |