| NPI | 1649012881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN D PASTOOR Executive Director 231-759-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |