| NPI | 1124271929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA SUE DUNAWAY Provider 810-736-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI as250084251) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI as250084250) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2008-10-24 |