| NPI | 1124342852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN IRA RANDALL Consultant 313-529-7002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS80294958) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-03-24 |