| NPI | 1154616274 |
|---|---|
| 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 AS130292696) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS110307861) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS110307861) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS130292696) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |