| NPI | 1922285113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI DIANA MILAN Sole Member 616-502-9064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301009500) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2008-01-30 |