| NPI | 1821435991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYM DICE Billing Manager 810-233-5340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2023-05-16 |