| NPI | 1447682158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC DANIELS STURDEVANT Select Residential Owner/Licensee R 269-579-3623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2024-05-29 |