| NPI | 1023317864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANNE TALBOT Clinical Social Worker 248-884-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801079628) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |