| NPI | 1730330747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN A. THORN Administrator 810-785-4324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AM250008168) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |