| NPI | 1659621597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY POPLAR Co Owner 269-998-9343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |