| NPI | 1538463914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI JO KRZCIOK Program Nurse 616-940-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MI 4703093649) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2010-12-29 |