| NPI | 1942675426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL SMITH Program Director 616-243-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI SA0410165) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |