| NPI | 1114317476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN RUSSELL ADAMS Clinician 313-402-7779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 6801088547) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |