| NPI | 1033293097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MCLUCKIE Executive Director 248-471-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AF630270844) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |