| NPI | 1639320708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA M BURNETT Owner/Licensee 810-743-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AM250067081) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AM250067081) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |