| NPI | 1275980005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE POLVERELLI Employee Healthcare Contact 616-248-5291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MI 320700000X) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |