| NPI | 1033624150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL DEWITT THOMAS Administrator 888-759-4917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201000744) |
| Additional Taxonomies | 101Y00000X Counselor |
| 163W00000X Registered Nurse (Licence: MI 4704213153REN17) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2020-11-30 |