| NPI | 1003498585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA ORNS-GRANT Owner 269-339-8531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-04-24 |
| Last Update Date | 2021-04-24 |