| NPI | 1174982227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN ANNE CORTS Owner 269-998-1859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801066650) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |