| NPI | 1083738371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL DENNIS FOWLER Owner President 734-483-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 810353) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |