| NPI | 1407361538 |
|---|---|
| Doing Business As | GLC THREE RIVERS |
| Entity Type | Organization |
| Authorized Contact | RHASHEDA SHEPHERD Contract And Compliance Manager 269-250-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |