| NPI | 1043431240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA PEREZ Director 269-387-7412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-11-14 |