| NPI | 1053724138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN E. LEAVITT Clinical Director 734-546-4811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801080546) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |