| NPI | 1063840221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCY BOS Program Director 269-532-1470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MI A2390299099) |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2013-10-28 |