| NPI | 1023560851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L GOODWIN Director 586-246-7837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401010236) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |