| NPI | 1235491556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M MCILVENNA Executive Director 989-835-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401010105) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |