| NPI | 1669937603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORINDA JUNE ANDERSON Director Qa 269-343-6355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-04 |