| NPI | 1194230227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHASHEDA SHEPHERD Contract And Compliance Manager 269-250-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MI AS390011417) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |