| NPI | 1801368550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH BLANKENSHIP Financial Director 269-344-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |