| NPI | 1295189173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY D PRUITT Owner 248-234-8533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |