| NPI | 1922469469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PER WICKSTROM CEO 231-218-4406 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI SA0510027) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |