| NPI | 1679024186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE M BAUDOUX Regional Office Coordinator 989-596-3558 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MI 6802087250) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6802087250) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6802087250) | |
| 101YP2500X Counselor, Professional (Licence: MI 6802087250) | |
| 1041C0700X Social Worker, Clinical (Licence: MI 6802087250) | |
| 106H00000X Marriage & Family Therapist (Licence: MI 6802087250) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 6802087250) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2022-07-21 |