| NPI | 1659654242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PER WICKSTROM CEO 231-218-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 510026) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2012-10-23 |