| NPI | 1609287655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA MAINVILLE Administrator 313-361-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0820103) |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2021-03-04 |