| NPI | 1952827107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY RIDGEWAY Program Director 616-243-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-08-19 |
| Last Update Date | 2025-03-25 |