| NPI | 1316351224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MILES TOUTANT CEO 906-228-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2024-11-04 |