| NPI | 1205985462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALESSIA JASINSKI-BRADFORD Case Manager 616-454-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |