| NPI | 1033455316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAJ MARIA EDWARDS Clinical Program Director 313-831-5535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6801061747) |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2012-12-14 |