| Organization Name: | FOUR HEALTH FAMILY RESOURCE CENTER |
| NPI Number: | 1073989141 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELISSA ANN-MOHNKE ATHMANN (CLINICAL DIRECTOR) |
| Mailing Address: | 92 N Bridge St Saranac |
| State: | MI US |
| Postal Code: | 488815102 |
| Phone Number: | 6166426466 |
| Fax Number: | 6166426621 |
| NPI Enumeration Date: | 08/12/2015 |
| NPI Last Update Date: | 08/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401007813 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |