| NPI | 1912343690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE A. TEUNESSEN Executive Director 269-838-6528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 130118) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MI 130118) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2014-05-30 |