| NPI | 1083055156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARYA JEAN COTTINGHAM Casemanager 248-871-1467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MI 6802076608) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 6802076608) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |