| NPI | 1114633179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSARETIN UWAIFO President 313-478-1734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-01-24 |