| NPI | 1083086649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN A HARTFORD Team Leader/Clinician 734-680-6425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |