| NPI | 1679051759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELL DENELL HARPER-SHELTON Executive Coordinator 810-238-7226 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2021-10-20 |