| NPI | 1164837431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAYNE CARLESS Manager 586-995-3861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MI 4704157745) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-06-25 |