| NPI | 1922019157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE FENNEMA Managed Care Administrator 616-281-6372 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2025-09-23 |