| NPI | 1538457932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY M PHELPS Owner 269-370-3038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301014756) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |