| NPI | 1023556099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE LAMBLE Interim Program Director 989-340-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401009162) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |