| NPI | 1902073653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD PATRICK MOSS Owner 616-842-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |