| NPI | 1427162239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED E. WIGEN President/CEO 989-777-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MI 730157) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 730157) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 730157) | |
| 104100000X Social Worker (Licence: MI 730157) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-01-02 |