| NPI | 1942963004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN CROTTE Co Owner 269-598-2499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2021-10-15 |