| NPI | 1629113089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY JEAN MILLIS Case Manager 616-774-8789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI 4) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-07-21 |