| NPI | 1104108828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA PITLANISH Sole Member 248-854-6351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801063928) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2013-06-12 |