| NPI | 1972156701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELL DENELL HARPER-SHELTON Executive Coordinator 810-238-7226 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2021-10-20 |