| NPI | 1104200526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARSHA RIGGIN Operator 734-846-1519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI As820313236) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |