| NPI | 1649733148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA JANE PENNINGTON Assistant 231-347-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2025-04-17 |