| NPI | 1992957542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ANDERSON Executive Director 269-788-0496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 130102) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 130123) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2015-09-01 |