| NPI | 1336829886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BIGBY Owner/Admin/Licensee 616-309-8205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2024-10-31 |