| NPI | 1093275596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PHELPS Finance Manager 734-544-6752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2019-03-21 |