| NPI | 1588020374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN SALO Supervisor 906-228-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MI 6801098960) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |