NPI | 1598007171 |
---|---|
Entity Type | Organization |
Authorized Contact | JORDAN P BOUDREAU Owner 231-497-0555 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 1-09-5852) |
Enumeration Date | 2013-03-21 |
Last Update Date | 2013-03-21 |