| NPI | 1912380684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE PYLE Counselor 269-967-2296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6401009580) |
| Additional Taxonomies | 251S00000X (Licence: MI 6802077897) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |