| NPI | 1316410681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARICIA R CARTER Administrator 248-495-8985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |