| NPI | 1184087272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT DAVID CARD Operations Manager 231-620-6788 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0280010) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI SA0280057) |
| 103T00000X Psychologist (Licence: MI 6301007174) | |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801088876) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0280085) | |
| 363A00000X Physician Assistant (Licence: MI 5601005691) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2018-06-28 |