| NPI | 1093000127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HIRAM ZAYAS Single Member 269-449-8291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS130292694) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MI AS130292694) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |