| NPI | 1306097191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILLE LOIS BOYD Owner 810-875-9633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MI AM250008164) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |