| NPI | 1972210888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX FEDOROWYCH CEO 616-272-6171 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2025-06-09 |