| NPI | 1194073908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP HERNANDEZ Recreation Aide 616-940-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |