| NPI | 1013217660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMANUEL T. VANBOLDEN Owner 248-333-1083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301013909) |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2010-10-29 |