| NPI | 1255783254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN LIEBNER Executive Director 517-897-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0330351) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI M318510) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2018-04-23 |