NPI | 1245531995 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACIE ANN HERNANDEZ CEO 269-317-4433 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS800309333) |
Enumeration Date | 2010-11-11 |
Last Update Date | 2010-11-11 |