| NPI | 1932378858 |
|---|---|
| Doing Business As | TEAL LAKE WOMEN'S RESIDENTIAL |
| Entity Type | Organization |
| Authorized Contact | KARY A HAMILTON Billing Manager 906-228-9699 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2024-08-05 |