| NPI | 1841464492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN MAGGIO Executive Director 906-337-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 310003) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |