| NPI | 1912327396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMME JOHNSON Manager 269-277-3070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401011898) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401011740) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2014-04-23 |