| NPI | 1003298191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RUGGENBUCK Social Worker 517-887-9712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI T326398630047) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |