| NPI | 1639631138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN W LABADIE Billing Analyst 269-343-1651 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |