| NPI | 1881961498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA MARIE KELLY Owner/Home Administrator 269-496-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MI As750239107) |
| Enumeration Date | 2011-11-27 |
| Last Update Date | 2011-11-27 |