| NPI | 1497358865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO DAVID TILLERY CEO 517-703-3387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251300000X Local Education Agency (LEA) | |
| 251B00000X Case Management | |
| 251K00000X Public Health or Welfare | |
| 253Z00000X In Home Supportive Care | |
| 261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
| 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-18 |