| NPI | 1952827107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY RIDGEWAY Program Director 616-243-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2017-08-19 |
| Last Update Date | 2024-10-22 |