| NPI | 1720376031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE HERNANDEZ CEO 269-317-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS120281503) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2011-07-20 |