| NPI | 1447020805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN ADIELE Nurse Practitioner 906-416-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 273R00000X Psychiatric Unit | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 314000000X Skilled Nursing Facility | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-05-23 |