| NPI | 1598946170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M. PETERSEN Associate Director 231-893-1462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MI AS610248796) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS610248796) | |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2007-11-23 |