| NPI | 1033539069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONETTE MARIE THOMAS Registered Nurse 586-783-8113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 163WP0808X) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |