| NPI | 1114135191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MARIE STADER Act Advocate 734-785-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801088571) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |