| NPI | 1720123706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M MONROE Vice President 517-628-2287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2021-03-26 |