| NPI | 1457780041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE MALABED Supervisor 269-492-7205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |