| NPI | 1679010169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ERIN HANSON Owner 810-336-7958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS250376556) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |