| NPI | 1467756221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE ANN HERNANDEZ CEO 269-317-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AM800267076) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |