| NPI | 1093021784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAM KANCHARLA Member 248-228-4115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |