| NPI | 1932300639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GRIB Clinical Director 269-382-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801082552) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |