| NPI | 1487275376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIEN L. SMITH Program Director 231-206-9612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-05-01 |