| NPI | 1528833365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES HOWARD RUOFF Licensee 269-578-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2023-11-21 |