| NPI | 1053590935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN A BRANCH-GADD Program Services Coordinator 810-966-1625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |