| NPI | 1902315385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY PIERCE Director Of Insurance Services 269-704-7564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2018-04-03 |